Loading...
HomeMy WebLinkAboutKEYSTONE CONTRUCTION- 002096- 7/25/2011CARMEL REDEVELOPMENT COMMISSION Keystone Construction 47 South PA St, 10th Floor Indianapolis, IN 46204 Invoice P.O. Num. 101005 P47 Streetscape 101006 App 101006 on P47 General Cond 101007 P47 streetscape Invoice Amt 27,437.71 28,968.52 28,968.52 24,636.04 24,636.04 002096 Check: 2096 Date: 7/25/2011 Vendor: KEYSTON1 Prior Balance Retention Discount Amt. Paid 27,437.71 0.00 0.00 27,437.71 0.00 0.00 28,968.52 81,042.27 81,042.27 0.00 • 0:00 24,636.04 k ?' THE KEY TO DOCUMENT SECURITY rHEAT`ACTIVATED THUMBPRINT • +ADDITIONAL,SECURITY :FEATURES INCLUDED, .SEE'BACK'.FOR DETAILS CARMEL Carmel Redevelopment. Commission 30 West Main Street Suite 220 Carmel, IN 46032 A- REGIONS 20- 1421/740 DATE 002096 2096 AMOUNT 7/25/2011 * * * * * * * ** *81,042.27 PAY THE SUM OF EIGHTY ONE THOUSAND FORTY TWO DOLLARS AND 27 CENTS * * * * * * * * ** * * ** * * * * * * ** TO THE ORDER OF - Keystone .Construction 47 South' PA St, 10th. Floor Indianapolis, IN 46204 u °00 20960 1:0740 14 2 L 31: 0087504 L L L" CARMEL REDEVELOPMENT COMMISSION Keystone Construction 47 South PA St, 10th Floor Indianapolis, IN 46204 002096 Check: 2096 Date: 7/25/2011 Vendor: KEYSTON1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 101005 27,437.71 27,437.71 0.00 0.00 27,437.71 P47 Streetscape 101006 28,968.52 28,968.52 0.00 0.00 28,968.52 App 101006 on P47 General Cond 101007 24,636.04 24,636.04 0.00 0.00 24,636.04 P47 streetscape 81,042.27 81,042.27 0.00 0.00 81,042.27 ( -11. 52 COMPUTEREASE'FORMS DIVISION (877)577 -5791 T -37228 APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE 1 OF 3 PAGES TO OWNER: PROJECT: Parcel 47 Streetscape City of Carmel Carmel, Indiana FROM CONTRACTOR: Keystone Construction Corp. 47 S. Pennsylvania Street Indianapolis, IN 46204 CONTRACT FOR: VIA ARCHITECT: APPLICATION NO: PERIOD TO: PROJECT NOS: CONTRACT DATE: 101007 6/27/11 1010 Distribution to: OWNER ARCHITECT CONTRACTOR CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached. 1. ORIGINAL CONTRACT SUM 2. Net change by Change Orders 3. CONTRACT SUM TO DATE (Line 1 ± 2) 4. TOTAL COMPLETED & STORED TO DATE (Column G on G703) 5. RETAINAGE: a. % of Completed Work $ (Column D + E on G703) b. 10 % of Stored Material $ (Column F on G703) Total Retainage (Lines 5a + 5b or Total in Column I of G703) 6. TOTAL EARNED LESS RETAINAGE (Line 4 Less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) $ 137,370.00 $ 0.00 $ 137,370.00 $ 124,258.57 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the 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. CONTRA By: i KEYSTONE CONSTRUCTION CORPORATION State of: Indiana Subscribed and 0.00 Notary Public: My Commission expires: 0.00 $ 124,258.57 $ 99,622.53 $ 24,636.04 13,111.43 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner Total approved this Month TOTALS $0.00 $0.00 NET CHANGES by Change Order $0.00 County of: Marion ,June, 20 1]1 Date: 6/27/2011 ANDREA M. ROELL NOTARY PUBLIC SEAL STATE nc UIruA i& ARCHITECT'S CERTIFICATE FOR P/j►YMENT �y MARION COUNTY In accordance with the Contract Documents, based on on -site obse ations and the datC0VEMOMMBEISSR ION 8, 2016 EXPIRES: P1 comprising the application, the Architect certifies to the Owner that to the best or trre Architect's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED $ 14,14'544041' (Attach explanation i mount certified differs from the amount applied. Initial all figures on this Application and .��Continuation heel that are changed to conform with the amount certified) ARCHITECT- By: Date: 4/30 / 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 rights of the Owner or Contractor under this Contract. • AIA DOCUMENT G702 APPLICATION AND CERTIFICATION FOR PAYMENT 1992 EDITION AIA 01992 r�,� THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-5292 Users may obtain validation of this document by requesting a completed AIAe for Oe eaeve1opmcatior1 of DQcument'sCAu ity from the Licensee. CONTINUATION SHEET AIA DOCUMENT G703 PAGE 2 OF 2 PAGES AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing Contractor's signed certification is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply APPLICATION NO: APPLICATION DATE: PERIOD TO: PROJECT NO: 101007 6/27/2011 6/30/2011 1010 A B C D E F G H I ITEM NO. DESCRIPTION OF WORK SCHEDULED VALUE WORK COMPLETED MATERIALS PRESENTLY STORED (NOT IN D OR E) TOTAL COMPLETED AND STORED TO DATE (D +E +F) % (G _ C) BALANCE TO FINISH (C - G) RETAINAGE (IF VARIABLE RATE) -_ FROM PREVIOUS APPLICATION (D + E) THIS PERIOD 1 General Conditions & CM Fee $137,370.00 $99,622.53 $24,636.04 $124,258.57 90% $13,111.43 - PAGE TOTAL $137,370.00 $99,622.53 $24,636.04 $0.00 $124,258.57 90% $13,111.43 _ . •. . V. I. I." • is ocumen .y reques ing o e icense a comp ete ocument D401 - Certification of Document's Authenticity AFFIDAVIT AND WAIVER OF LIEN Final State of Indiana, County of Marion. SS: X Partial X Payment to Follow Christi Minars, being duly sworn, states that she is the Controller of Keystone Construction Corporation (Contractor) having contracted with Carmel Redevelopment Commission to furnish certain materials and /or labor as follows for a project known as Parcel 47 Streetscape, located at Carmel Indiana and does hereby further state on behalf of the aforementioned Contractor. (PARTIAL WAIVER) that there is due from the owner the sum of Twenty Four Thousand Six Hundred Thirty Six & 04/100 Dollars ($ 24,636.04 ) [ ] receipt of which is hereby acknowledged ; or [ X ] the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned ; (FINAL WAIVER) that the final balance due from the owner is the sum of Dollars ($ ). [ ] receipt of which is hereby acknowledged; or [ ] the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all lien or claim whatsoever on the above - described property and improvements thereon on account of LABOR or MATERIAL or both, furnished by the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work performed or material furnished to the unde signed for said project, and within the scope of this affidavit and waiver. Keystone Construction Corporation By/ 4%1 Title Controller (Company) WITNESS MYII AND AND Notary I- OTARIA (Author] ed Representative) EAL, this 27th day of June, 201 I . tate of Indiana County of Marion iblic: Printed Name. Andrea iYl. Rocll ANDREA M. ROELL NOTARY PUBLIC SEAL STATE OF INDIANA MARION COUNTY MY COMMISSION EXPIRES: NOVEMBER 8, 2016 es November 8. 2016 APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE 1 OF 3 PAGES TO OWNER: PROJECT: Parcel 47 Streetscape City of Carmel Cannel, Indiana FROM CONTRACTOR: Keystone ConstructionCorp. 47 S. Pennsylvania Street Indianapolis, IN 46204 CONTRACT FOR: VIA ARCHITECT: APPLICATION NO: PERIOD TO: PROJECT NOS: CONTRACT DATE: 101006 5/30/11 1010 Distribution to: OWNER ARCHITECT CONTRACTOR CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached. 1. ORIGINAL CONTRACT SUM 2. Net change by Change Orders 3. CONTRACT SUM TO DATE (Line I ± 2) 4. TOTAL COMPLETED & STORED TO DATE (Column G on G703) 5. RETAINAGE: a. % of Completed Work $ (Column D + E on G703) b. 10 % of Stored Material $ (Column F on G703) Total Retainage (Lines 5a + 5b or Total in Column I of G703) 6. TOTAL EARNED LESS RETAINAGE (Line 4 Less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) $ 137,370.00 $ 0.00 $ 137,370.00 $ 99,622.53 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the 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. CONTRACTOR: KIYSTONECONSTRUC By: N CORPORATION State of: Indiana County of: Subscribed and sbyorn to before me etthi 25th day of Ma 0.00 Notary Public: ��� My Commission expires: DREA M. ROELL Date: 5/2 'pG RY PUBL SEAL anon STATE OF INDIANA 2011 MARION COUNTY MY COMMISSION EXPIRES: NOVEMBER 8, 2016 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT 99,622.53 In accordance with the Contract Documents, based on on -site observations and the data comprising the application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, 70,654.01 the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. $ 28,968.52 37,747.47 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved months in previous months by Owner ._ Total approved this Month TOTALS $0.00 $0.00 NET CHANGES by Change Order $0.00 AMOUNT CERTIFIED (Attach explanation Application an ARCHITEC By: $,4416 2. mount certified differs from the amount applied. Initial all figures on this Continuatio Sheet that are changed to conform with the amount certified.) Date: f ja(f (/ 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 rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 APPLICATION AND CERTIFICATION FOR PAYMENT 1992 EDITION AIA ©1992 THE AMERICAN INSTITUTE 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 - Certification of D cument's Authenticity from the Licensee. Director of Redevelopment /(/jtf 17 CONTINUATION SHEET AIA DOCUMENT G703 PAGE 2 OF 2 PAGES AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing Contractor's signed certification is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column 1 on Contracts where variable retainage for line items may apply APPLICATION NO: APPLICATION DATE: PERIOD TO: PROJECT NO: 101006 5/25/2011 5/31/2011 1010 A B C D E F G H I ITEM NO. DESCRIPTION OF WORK SCHEDULED VALUE WORK COMPLETED MATERIALS PRESENTLY STORED (NOT IN D OR E) TOTAL COMPLETED AND STORED TO DATE (D +E +F) % (G =C) BALANCE TO FINISI -I (C - G) RETAINAGE (IF VARIABLE RATE) FROM PREVIOUS APPLICATION (D + E) THIS PERIOD I General Conditions & CM Fee $137,370.00 $70,654.01 $28,968.52 - $99,622.53 $0.73 $37,747.47 - PAGE TOTAL $137,370.00 $70,654.01 $28,968.52 $0.00 $99,622.53 $0.73 $37,747.47 _ Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity AFFIDAVIT AND WAIVER OF LIEN Final Partial Payment to Follow State of Indiana, County of Marion. SS: Terry Eyster, being duly sworn, states that he is the Superintendent of Keystone Construction Corporation (Contractor) having contracted with Carmel Redevelopment Commission to furnish certain materials and /or labor as follows for a project known as Parcel 47 Streetscape, located at Carmel Indiana and does hereby further state on behalf of the aforementioned Contractor. X X (PARTIAL WAIVER) that there is due from the owner the sum of Twenty Eight Thousand Nine Hundred Sixty Eight & 52/100 Dollars ($ 28,968.52 ) [ ] receipt of which is hereby acknowledged ; or [ X ] the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned ; (FINAL WAIVER) that the final balance due from the owner is the sum of Dollars ( $ [ ] receipt of which is hereby acknowledged; or [ ] the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all lien or claim whatsoever on the above - described property and improvements thereon on account of LABOR or MATERIAL or both, furnished by the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Keystone Construction Corporation By (Company) Title Superintendent WITNESS MY HAND AND NOTARIAL SEAL, this 25th day of May, 2011. Notary Public: 14106414 Printed Name: Andrea M. Roell at °ol ANDREA M. ROELL NOTARyptalossion Expires No SEAL STATE OF INDIANA MARION COUNN W COMMISSION EXPIRES: NOVEMBER 8, 2016 Iarion ember 8. 2016 Application and Certificate for Payment TO OWNER: City of Carmel ' "'fi PROJECT: Parcel 47 Streetscaoe Cannel, Indiana FROM CONTRACTOR: Keystone Construction CorporrARCHITECT: 47 S Pennsylvania Street FL 10 Indianapolis, IN 46204 APPLICATION NOr= =101005 PERIOD,TO:r, '4/26/2011 CONTRACT FOR: 'rtrCONTRACT DATE: PROJECT NOS: 1010 Distribution to: OWNER ❑ ARCHITECT ❑ CONTRACTOR ❑ FIELD 0 OTHER ❑ CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. AIA Document G703Tm, Continuation Sheet, is attached. 1. ORIGINAL CONTRACT SUM 2. NET CHANGE BY CHANGE ORDERS 4 $ 3. CONTRACT SUM TO DATE (Line 14 2) $ 70,654.01 4. TOTAL COMPLETED & S70RED }:T "O:I)ATE (Column Gon G703) $ 70,654.01 5. RETAINAGE: s a. % ofG•`,oi iplefed Work (Coles ns D +Eon G703) b. =-'; •d /o •of Stored Material (Column F on G703) $ 70,654.01 , 0.00 $ Total Retainage (Lines 5a + 5b, or Total in Column .1 of G703) $ 6. TOTAL EARNED LESS RETAINAGE $ (Line 4 minus Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETNNAGE.';. (Line 3 minus Line 6) The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the 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. a•. CONTRACT • ; Key ton/ r • struction Corpdrai 0n"='•, By: State of: In Lana County of: Marion Subscribed and sworn,to', me this a 10 `- daj�,of Notary Public:' 0.00 My commission expires: Date: 4:11 •'.%W 1 1 ( ANDREA TARRY PIJBUC SEAL MARION co SAY OOMMIS$4ON EXPIRES: NOVEMBER 8, 2016 70,654.01 ARCHITECT'S CERTIFICATE FOR PAYMENT 43,216.30 27,437.71 0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved lit previous months by Owner $ $ Total approved this month $ $ • TOTAL $ $ NET C}ANGES b Chan :e Order $ In accordance with the Contract Documents, based on on -site observations and the data comprising this application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed a indicated, the quality of the Work is in accordance with the Contract Documents ontiactor is entitled to payment of • the AMOUNT CERTIFIED/ AMOUNT CERTIFIED r ... ` $ // ,�7 /I (Attach explanatir • If aunt c tiled d eYSf . .mou applied. Leila all figure on this Application .'.. o • t Con uatlon Shee1.that are changed to conform with the amount certified.) ARCHITE By —!,. Date: 4.11,$/// This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named hereinr. =Issui'fnce` ■ payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. l 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 0702 ', —1992. Copyright C 1953, 1983, 1965, 1971, 1978, 1983 and 1992 by The American Institute of Architects. All lights reserved. WARNING: This Ate Document is protected by U.B. 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. Director of Redevelopment /UJ.1.f AlA Document G7O3TM -1992 Continuation Sheet AIA Document G702114-19512,W ieation and Certificate for Payment, or 0732Thz -2009, Application and Certi ipat8ifoiCl1 yment, Construction Manager as Adviser Edition, containing Contrtcors igned certification is attached. In tabulations -be:14W1,',amounts are in US dollars. Use Co oWU t ';b {tContracts where variable retainage for line items may apply. APPLICATIONING ` 101005 APELIC6TION. DATE: 4/26/2011 RICO To: 4/26/2011 ARCHITECT'S PROJECT NO: 1010 A u. B C D E 0 H I ITEM NO. DESCRIPTION OF WORK SCHEDULED VALUE WORK COMPLETED MATERIALS PRESENTLY STORED (Not in D or E) TOTAL COMPLETED AND STORED TO DATE (D +E +F) % (C + C) BALANCE TO FINISH (C _ G) RETAINAGE (If variable rate) FROM PREVIOUS APPLICATION (D + E) THIS PERIOD 1 General Conditions to Date 42,906.1 34,268.6 8,637.4: 42,906.1 100.01 2 5% CM Fee to Date rs f ti; 27,747,8: 8,947.6 18,800.2- 27,747.8: 100.0,1 y i F • 1.S'Ssr'1 TOta�Is GRAND TOTAL 70,654.0 43,218. + 27,437.7 70,654.0 100.11 CA TION: 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 G7O3TM —1992. Copyright a 1983, 1965, 1966, 1987, 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, copyrightataia.org. uq,wow. AFFIDAVIT AND WAIVER OF LIEN 0 Final State of Indiana, County of Marion. SS: Partial C Payment to Follow Matt Stump, being duly sworn, states that he is the Senior Project Manager of Keystone Construction Corporation (Contractor) having contracted with Cannel Redevelopment Commission to furnish certain materials and/or labor as follows for a project known as Parcel 47 Streetscape, located at Carmel Indiana and does hereby further state on behalf of the aforementioned Contractor. (PARTIAL WAIVER) that there is due from the owner the sum of Twenty Seven Thousand Four Hundred Thirty Seven & 71/100 [ ] receipt of which is hereby acknowledged ; or Dollars ($ 27,437.71 [ X ] the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned ; (FINAL WAIVER) that the final balance due from the owner is the sum of Dollars .( $ ). [ ] receipt of which is hereby acknowledged; or [ ] the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all lien or claim whatsoever on the above - described property and improvements thereon on account of LABOR or MATERIAL or both, furnished by the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Keystone Construction Corporation By Title Senior Project Manger (Company) ( I :tied Rcpresentativ WITNESS MY HAND AND ARIAL SEAL, this 26th day of April, 2011. Notary Public: Printed Name: Andrea M. Roell State of Indiana County of Marion ANDREANCREIGLision Expires Nttientber 8, 2016 NOTARY PUBLIC SEAL. STATE OF INIX NA MARION COUNTY W COMMISSION NOVEMBER 8, 2 6 OV