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LAFEVER ELECTRIC, INC.- 002494- 12/5/2011CARMEL REDEVELOPMENT COMMISSION LaFever Electric, Inc. 131 N Rangeline Road Carmel, IN 46032 Invoice 3- P.O. Num. App 3 on P112.Wayfinding 002494 Check: 2494 Date: 12/5/2011 Vendor: LAFEVER1 Prior Invoice Amt I Balance Retention Discount Amt. Paid 178,490.71 178,490.71 0.00 0.00 178,490.71 178,490.71 178,490.71 178,490.71 THE KEY TO!DOCUMENT SECURITY •°HEAT ACTIVATED,THUMB PRINT ADDITIONAL'' SECURITY FEATURES SINCLUDED k SEE'BACKFOR DETAILS, :, STRIG •tea Carmel Redevelopment .Commission 30 West Main Street Suite 220 `,Carmel, IN 46032 • DATE; 2494 AMOUNT PAY TO THE ORDER OF 12/5/2011 * * * * * *" *178,490:71 THE SUM OF ONE, HUNDRED SEVENTY,EIGHT THOUSAND FOUR HUNDRED NINETY DOLLARS AND 71 CENTS. *' *' * * * *** * ** LaFever-Electric;'lnc. 131N Rangeline Road Carmel, IN 46032; i1°002494» 1 :0740 31: 0087SO4LL II° CARMEL REDEVELOPMENT COMMISSION LaFever Electric, Inc. 131 N Rangeline Road Carmel, IN 46032 002494 Check: 2494 Date: 12/5/2011 Vendor: LAFEVER1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 3- 178,490.71 178,490.71 0.00 0.00 178,490.71 App 3 on P112 Wayfinding 178,490.71. 178,490.71 0.00 0.00 178,490.71 X -11- 52 COMPUTEREASE FORMS DIVISION (877)5775791 T -37228 APPLICATION AND CERTIFICATE FOR PAYMENT TO OWNER: Carmel Redevelopment Commission PROJECT: P112 Wayfinding & Site Amenities APPLICATION NO 3 30 West Main St., Suite 220 720 S. Rangeline Road PERIOD TO: 10/31/2011 Carmel, IN 46032 Carmel, IN 46032 PROJECT NO: 0 FROM CONTRACTOR: LaFever Electric, Inc. VIA PROJECT MANAGER: Signature Construction JOB NO: 1789 131 N. Rangeline Road 720 3rd Avenue SW CONTRACT DATE 6/15/2011 Carmel, IN 46032 Carmel, IN 46032 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance 1 ORIGINAL CONTRACT SUM $ 282,900.00 with the Contract Documents, that all amounts have been paid by the Contractor for Work for 2 NET CHANGE BY CHANGE ORDERS $ which previous Certificates for payment were issued and payments received from the Owner, 3 CONTRACT SUM TO DATE (Line 1 ± 2) $ 282,900.00 and that current payment shown herein is now due. 4 TOTAL COMPLETED AND STORED TO DATE $ 235,949.50 (Column G on G703) 5 RETAINAGE: 10 % of Completed Work $ 9,762.28 (Columns D +E) 10 % of Stored Material $ 13,832.67 (Column F) Total Retainage (Line 5a + 5b or Total in Column I) 6 TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7 LESS PREVIOUS CERTIFICATES FOR PAYMENTS (Line 6 from prior Certificate) 8 CURRENT PAYMENT DUE (Line 6 less Line 7) 9 BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) $ 70,545.45 CONTRACTOR: LaFever Electric, Inc. Chris A. LaFever $ 23,594.95 State of: Indiana $ 212,354.55 County of: Hamilton Subscribed and sworn to before Li" m 7ph d of October, 21 . ic: Colleen 'S J 1arvel ' o; $ 33,863.85 $ 178,490.71 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner _ - Total approved this month - - TOTALS - - NET CHANGES by Change Order - My Commission expires: April 11, Date: October 17, 2011 rrsc+n�:� hDlaltctterr- s /0301 JOB NAME APPLICATION NUMBER P112 Wayfinding & Amenities 3 APPLICATION DATE PERIOD TO 10/17/2011 10/31/2011 PAGE NUMBER 1 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 FROM PREVIOUS APPLICATION (D +E) THIS PERIOD - BASE BID - - 1.00 Conduit, box, fittings, ETC. M 15,300.00 14,535.00 535.50 229.50 15,300.00 100 - 1,530.00 - - L 15,863.00 3,172.60 11,104.10 14,276.70 90 1,586.30 1,427.67 2.00 Wire M 10,453.00 - 9,407.70 1,045.30 10,453.00 100 - 1,045.30 - - L 8,689.00 - 7,820.10 7,820.10 90, 868.90 782.01 3.00 Concrete and Core Drilling M 11,636.00 4,654.40 4,188.96 2,792.64 11,636.00 100 - 1,163.60 - L 2,341.00 936.40 1,404.60 2,341.00 100 - 234.10 4.00 Lighting M 151,460.00 3,029.20 14,843.08 133,587.72 151,460.00 100 - 15,146.00 - - L 9,363.00 - 936.30 936.30 10 8,426.70 93.63 5.00 Allowance 40,000.00 - 6,283.00 6,283.00 33,717.00 628.30 1.00 Alternate #2 - - Conduit, box, fittings, ETC. M 3,650.00 3,467.50 73.00 109.50 3,650.00 100 - 365.00 - - L 3,777.00 755.40 1,510.80 2,266.20 60 1,510.80 226.62 - Wire M 1,405.00 - 843.00 562.00 1,405.00 100 - 140.50 - - L 1,027.00 - 616.20 616.20 60 410.80 61.62 - Lightiing M 3,681.00 3,681.00 3,681.00 100 - 368.10 - - L 860.00 - 430.00 430.00 50 430.00 43.00 - Bond 3,395.00 3,395.00 - - 3,395.00 100 - 339.50 _ 282,900.00 37,626.50 59,996.34 138,326.66 235,949.50 ■ 46,950.50 23,594.95 Mato Of Indiana County of Hamilton TO WHOM IT MAY CONCERNS WHEREAS the undersipted bee been worinyed by to finish WAIVER OF LIEld TO DATE iss LaFever Electric, Inc. File d: Electrical Work bar the gentian described es of which P112 Wayfinding & Site Amenities mew me ..'m.e,.im,weon. Carmel Redevelopment Commission Is the aim ar One Hundred Sever ehtud Flu 6Hindred Ninety Dollars and Seventy -one Cents ($ 178,490.71 )DOW. sod attar good and valuable mnsrdoatlos, the receipt whermt is bet dry ar tnowledend, do(es) Malty ware and lek td e 211 and 111 lien or deka or right of lien under the Si tateo ante Sum sdiarsin the land is lamed, relating to I,4edranie*s liens, on the above described maisea e n d tents t h e m e , and on the e n s u e s o r o t h e r considerations Otte a t to become doe from the owtlet, on asses eel of tabor or eenieaso, uutterial, Oxman or appernbns hrID rare &mld,ed to than data by the undersigned he the above deterlbad piaattese. sited this 17th dhr e>f October zo 11 Chris A. LaFcvcr, Vice-President Sol All wawa want be for Mee fun smoant paid. if waiver is for a torpor/dim. corporate mune +heeld be teed, corporate read sifted ated tido of offer sludge waiver ahoedd be set fonht tf weber is fir a rerun-ship, the panteeram'p eerie should be weed. Farmer almnid tau and designate htmsdrar water. CONTRACTOR'S AFFIDAvIt }sS Simi of Indiana County of Hamilton TO W1R W rr MAY CONCERN: WE enrtersignal. being duly swart�, deposes and says that he Is LaFever Electric, Inc. Vice- President who is the contractor Sir the Electrical Work keg located at list Street NW, Carmel, Indiana 46032 owsost by evelo ment Commission work on aid That the tonal eatatn rt albs emend bteiadhtgcaoaasis$ 282. 900.00 oil 'With he has 000vivvdpeytnentof s 22, 792.95 prior to this payment_ not all waives are ere, coma tmd ermine and Other rod unconditionally s d fiat theta is no Oahu either lapel or equitable to defeat the validity of said waivers. That the Mewing we the namss all all patties wb have nentsbcd tenurial or tabor, or both, /brisk' trek and all patties having contracts or snbaeeareats Ibr speotfle partioos ofsoid wont or for meow entwine into tpe seat WWI motor ow too enowrs One or SO bwwu dim to etch, sod that the items isoniand enslnded all tabor and 1411101tbd m teeid 'Mk at Oleg to daft and • -1 -., ohs: MANS entr ectrie u Techlite 31 578 -2626 IMTI O DICEIMMENIIIIIIMIIII tiwtu rev DO other uoin fur amid work outstanding and . at thane is nothing dos or to become due to any peso t :. Jmateriel, tabor or ortrir wotlr sty kind doe or 10 he done Capon or in cue nowise with said sett onion then above statet skim" this 17th day of October , 20 11 Subscribed and sworn to bcfre ntr Gigs 17th day of TS1 CD1606107f2oo7 ,1,1111 ;:; Chris A. LaFever Vice- President gimamd Frescribed by 1 tate Board of Accounts ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL City Form No. 201 (Rev. 1995) An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee La Fevtr Sect -r 1 c I hC . Purchase Order No. i 131 N. If any e \ e l' U. Terms Civ mel 1 N V '1 032 Date Due , Invoice Date Invoice Number Description (or note attached invoice(s) or bill(s)) Amount 10 -311 3 r11Z NitiNf;ndih9 c S; +e c1mehi tie S 178)14.9x. -1l Total 178 , - 9 0.71 a•∎ -v... dite: -1 /el.- — 1� :A k-1 I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct with IC 5- 11- 10 -1.6. I .–o ___ , 20 1 1 easurer e in accordance VOUCHER NO. WARRANT NO. LaFVer EIec%ric I 3 I IV RanieIine Rd, Cannel, I// 4.6132 $ 1-1g 410.71 ON ACCOUNT OF APPROPRIATION FOR � 02/ 1446o0s PO# or DEPT. # INVOICE NO. ACCT#/TITLE 2 3 Lty-tonc AMOUNT 179f9U.7/ Cost distribution ledger classification if claim paid motor vehicle highway fund ALLOWED 20 IN SUM OF $ Board Members I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 1(;') -.201 erector Cannel Redevelopment Commissi