The URL can be used to link to this page

220935 06/18/2013 CITY OF CARMEL, INDIANA VENDOR: 367176 Page 1 of 1 i ONE CIVIC SQUARE ANDREWS CONSTRUCTION CO CARMEL, INDIANA 46032 7808 MARQUIS LANE CHECK AMOUNT: $15,300.00 INDIANAPOLIS IN 46260 CHECK NUMBER: 220935 CHECK DATE: 6118/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460807 2 15, 300 . 00 PERFORMING ARTS CENTE I (|nntri,cUnneon reverse Side) `AeowsoF r*C-Fs -V � �_�_� �_�_�_� ��_ �/ .! [PPLICATION AND CERT» ..._____ PROJECT- APPLICATION Distribution (OWNER): ' � � �^ r�na\ Red'vo|uomontCommission Carmel �uiiadium Steel Retrofit 2013 XDyVNER \xV Main Street, Suite 220\ Carmel, IN 46032 PER|DDTO:5-31'2O13 ARCHITECT CONTRACTOR �-Fz[ N (CONTRACTDR): - VIA (ARCHITECT): ARCHITECT'S I eu Construction Cu - -~uuS K ,,^= PROJECT N& yTRACT FOR:Steel Retrofit X;3 CONTRACT DATE: ` Application m made for Payment,ax shown ou/vw m connection with the Contract. " ~ APPLICATION FO PAYMENT Continuation Sheet,A|A Document-- G703, is --- d. CONTRACTOR _-_---�--- -- 1. ORIGINAL CONTRACT SUM... ........................................... CHANGE ER SUMMARY 2.._N_e__t-__ohongebv Change Orders ------------- $ Change Orders approved in ADDITIONS DffDUCTIONS 3. CONTRACT SUM TO DATE(Line 1 ±2) ---------' $ 4.TOTALCOMPLETED&GTOREDTODATE -------' \ (Column GonG7O3 Month 5. RETA|NAGE: Date Approved_ A 1 %of Completed Work� (Column D+ EonG703 b %of Stored Material $ 3,780 (Column FnnB7O3) Total Retoinago (Line 5a+5bor Total in Column | uf8703) ...-' ' ' $ 0.TOTAL EARNED LESS RETA|NAGE .................................. Net change by Change Orders (Line4 less Line The ignndComo,�nron��es that Vu the boa nf the Cuntna��o�oknow|eJQe. 7LESS PREVIOUS CERTIFICATES FOR information and boUa(the Work covered by this Application for Payment �on been PAYMENT ` O from prior Certificate)t*) _______ completed in accordance with the Contract Documents, that all amounts have been 8 CURRENT PAYMENT DUE ______________ Work or which previous Certificates f ' Payment w * paid by the Contractor for °� 8ALANCE "FINISH, PLUS RETA|NAGE --------. \ reooivo� m �ho0wner. onU �ho� uu/ro � pmyman� xho�n ionuedandpaymon heron�nu�due� (L�e3�nuL�e0) CO'`''' CT O ' County Date, 50lU13 Subscribed and sworn m before me this day of 119 "y� Notary Public: ��K��«�� U�U�� /�� @yC�mi�iun��es: the data comprising the above application, the Architect certifies to the Owner that to (Attach exj,)Ianation if amount ceitified differs from the amount applied'for) the best of the Architect's knowledge, information and belief the Work has e Contract progressed as indicated, the quality of the Work is in accordance with th Documents, and the Contractor is entitled to payment ofthe AMOUNT CERTIFIED. By: Date- This Certifi6ant� is not negotiable, The AMOUNT CERTIFIED is payable only to the A. Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. ARCHITECT'S ,`°, , , ~~ , _~, ~ , , , , ,,,~~,, , G702'1983 `. ��w�n��Y��m�*�� Martial Lien Waiver WHEREAS. Andrews Construction Co, 7805 Marquis Lane, Indianapolis,IN 46260. "Contractor", has been heretofore employed by Carmel Redevlopment Commission,30 W Main street, Suite 220 Carmel,IN 46032.to furnish certain material., supplies, equipment, and/or labor for or in connection with improvements owned by Cal-Mel Redevelopment Commission and located at Carmel Palladium, Steel Retrofit,One Center Green, Carmel, IN 46032, hereinafter collectively referred to as the "Premises:" and WHEREAS, the undersigned is duly authorized to execute the Waiver of Lien for and on behalf of the Contractor: NOW;THEREFORE,the contractor, for and in consideration of the receipt of Fifteen thousand Three hundred and -------00/100 Dollars $15,300.00 hereby waives and releases the Owner of the Premises and the Company from any and.all,liens,rights of lien or claims of whatsoever kind or character on.or against the Premises or the improvements located thereon account of any and all labor, supplies, equipment,material furnished for, in connection with or incorporated in the Premises by the Contractor on or before the date thereof.: represents and warrants that no other person or party has any right to a lien or claim on account of any labor or work performed or material, supplies, or equipment furnished to, to or through the Contractor, on or before the date hereof, and agrees to indemnify, defend and hold the Owner and the Company harmless from and against anv and all claims or liens for any labor, material,. or services furnished to the date hereof. This Waiver of Lien is given in order to induce the Company to pay the amount indicated above,and upon receipt of such amount by the Contractor, this release may be recorded, becomes valid, enforceable and to full effect. Andrews Construction Co LLC Name of Contractor t' Authorized Representative Date: - 5 C1 State of Indiana County ofd- Before me, a Notary Public in and for said County and State,personally appeared, who acknowledged the execution of the foregoing Waiver of Lien, and who, having been duly sworn, stated that the representations therein contained are true. Witness my hand of Notorial Seal this 3 u day of 1 r1 6(,1 201 My Commission Expires��;1"� Notary Public Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995) CITY OF CARMEL 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 Andrews (41on ( 0 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) m 3trej rJrof& l5' 300.Cb Total I S 3 I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5-11-10-1.6. 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 ffl�dY'�h'y C O�1�j�rGIGT�On �0 IN SUM OF $ ON ACCOUNT OF APPROPRIATION FOR q02./ tf q 60807 Board Members PO#or DEPT.# INVOICE NO. ACCT#!TITLE AMOUNT I hereby certify that the attached invoice(s), or 902— 2- 4�� 7 5 3Qd°� 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 20 gnature Title Cost distribution ledger classification ifXa�� claim paid motor vehicle highway fund ` ,Instructions nn reverse Side) PAnCowcor PAC-Cy APPLICATION AND lFUICA~~ PAYMENT A� DOCU�ENTG702 _______________________________________ _ 'TO (OWNER): PROJECT: APPLICATION NO� 2 Distribution to'. Carmel Nadove|oomwntCommimuion Carmel Palladium Steel Retrofit 2013 XOVVNER 30 VV Main Street, Suite 220, Carmel, IN 46032 pER|ODT0:5'31-2013 ARCHITECT C0NTAACTOR FROM (CONTRACTOR): VIA(ARCHITECT): ARCHITECT'S ' Andrews Construction Co PROJECT NO: ~7��6�� N� K . `= � CONTRACT FOR:Steel Retrofit — -- — CONTRACT DATE: Ap lication is made for Payment, as shown below,in connection with the Contract. | CONTRACTOR'S APPLICATION FOR PAYMENT Continuation Sheet,A|A Document G7O3. iSattached. 'v | 1. ORIGINAL CONTRACT SUM.............................................. s � CHANGE ORDER SUMMARY �-_��1_ohengebvChmnQ� Orders ------------- $ ADDITIONS Change Orders approved in DEDUCTION� J. CONTRACT SUM T0 DATE(Line 1 ±2) ---------' $ previous months by Owner 4. TOTAL COMPLETED&STORED TO DATE ....... ............... TOTAL (Column GonG7O3 5. RETA|NAGE: | A 1 %of Completed Work� (Column O+ EonG703 b 96ofStored Material $ 2J960 ! I (Co|umnFonG703) | Tou| Retminuge(Line 5u+5bor ' Total in Column | ofG7O3) — '—' '— '.. .— '¢ 5.TOTAL EARNED LESS RETA|NAGE -----------. ' (Line 4less Line 5 Total) The unonm/gnnu Contractor certifies that to the Uoet of the Contractor's knowledge, 7. LESS PREVIOUS CERTIFICATES FOR information and belief the Work covered by this Application for Payment has been PAYMENT O from prin,Co�ihca|o} i completed in accordance with the Contract Documents, that all amounts have been 8 CURRENT PAYMENT � paid by the Cortnadnrfor YVork for which previous Oe�i�oa\ae for Payment were � ' '`''-~` ----------------� 9 BALANCE PLUS issued and payments received from the Ovvner, and that current payment shown � ' ................... herein is now due. (Line 3 less Line 0) CO�TRACTOR� / � �".a.= ".: ^uuv u/� By: Scott Andrews Date'. 5/2Q/2013 Subschbpdand nwnmtnbny mmoVnin day of ./S Notary Public: ' ARCHITECT'S CERTIFICATE FOR PAYMENT My Commission expires: In accordance with the Contract Documonts, based on on-site obsonmhunu and AMOUNT CERT|F|ED—.............. ............................................. ' the data comprising the above application, the Architect certifies to the Owner that to (Attach oxnlanmtiomif amount oettifixd �� ' ' '\ho best of the Architect's know|edgo, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract ` — uocumentn, and the Contractor in entitled m payment cl the AMOUNT CERTIFIED. 8y: Date- This Certificate is not negotiable, The AMOUNT CERTIFIED is payable only tnthe Contractor named herain. |»nuanoo, payment and oorop\anno of payment are without . prejudice*o any rights of the Owner nr Contractor under this Contract. ' THE Amcn/oxw INSTITUTE op*mcmTsnTo.1rno NEW YORK Avsnos.m�w «womwmmw D.C.x�no G702'1803 i ' ' El 0 C 1_1 A",E'N 7 G 703 it) I rj o ri s o) 'i F:,,v e.1- s i d,e f I AG E P A G C0NT'h,1`.AA'TQN SKEET p�A AIA DoculTIP!,it G702, �-,PPLICATION AND CF.RT;;Fl CATE FOR PAYNIENT, containing APPLICATICN NUI\413ER: 2 Contractor's signed Certification is attached. APPLICATION DATE: 5-29-2013 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 5-31-2013• Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: F G H A B I I — - I —OETAINAGE ITEM' DESCRIPTiON OF WORK SCHEDULED WORK COMPLETED ED I MATERIALS TOTAL BALANCE PRESENTLY COMPLETED TO FINISH NO.! VALUE FROM PREVIOUS THIS PERIOD 1 STORED AND STORED (C—G) APPLICATION (NOT IN TO DATE (D+E) D OR El (D+E+F) 1 General Conditions $4,000 $ 1.800 $ 1,800 $ 3,600 go $ 400 $ 360 2 Performance and Payment Bond $ 1,200 $ 1,200 so $ 1,200 100 $ 0 $ 120 II 3 Scaffolding $ 22.700 $ 7,500 i $ 16,200 $ 22,700 100 $ 0 2,270 4 Masonry $ 3,000 $ 0 $ 0 I $ 0 0 $ 3;000 $ 0 1 5 Fire Proofing $ 4,200 $ 0 $ 0 $ 0 0 $ 4:200 0 I � C .......... $ 35,100 10,500 $ 17,000 $ 27,500 78 $ 7.600 $ 2,750 AM DOCUMENT G-703--A*-IO-'P-L*I*C*'-A--T1--0-N,A—N--D,--C**'E'RT--I-F*l CATE FOR PAYMENT•MAY 1983 EDITION•AIA'•t 1983 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,N.W.,WASHINGTON,D.C.21J306 G703-1983 Partial Lien Waiver WE1ER1 AS. Andrews Construction Co, 7808 Marquis Cane, Indianapolis,IN 46260. "-Contractor", has been heretofore employed by Carmel Redevlopment Commission,30 W Main street, Suite 220 Carmel,IN 46032. to furnish certain material, supplies, equipment. and/or labor for or in connection with improvements owned by Carmel Redevelopment Commission and located at Carmel Palladium, Steel Retrofit,One Center Green,Carmel, IN 46032, hereinafter collectively referred to as the "Premises:" and WI-11RlAS, the undersigned is duly aurhorized to execute the Waiver of Lien for and on behalf of the Contractor: NOW,THEREFORE.the contractor, for and in consideration of the receipt of Fifteen thousand 'Three hundred and -------00/100 Dollars $15,300.00 hereby waives and releases the Owner of the Premises and the Company from any and all liens, rights of lien or claims of whatsoever kind or character on.or afainst the Premises or the improvements located thereon account of any and all labor, supplies, equipment,material furnished for, in connection with or incorporated in the Premises by the Contractor on or before the date thereof: represents and warrants that no other person or party has any right to a lien or claim on account of any labor or work perfornied or material, supplies, or equipment furnished to, to or through the Contractor. on or before the date hereof, and agrees to indemnify, defend and hold the Owner and the Company handless from and against anv and all claims or liens for any labor, material, or services furnished to the date hereof. This Waiver of Lien is given in order to induce the Company to pay the amount indicated above, and upon receipt of such amount by the Contractor, this release may be recorded. becomes valid, enforceable and to full effect. Andrews Construction Co LLC Name of Contractor Authorized Representative Date: State of Indiana County of=- am t-1��r•�r tz�. Before me, a Notary Public in and for said County and State, personally appeared, who acknowledged the execution of the foregoing Waiver of Lien. and who, having been duly sworn, stated that the representations therein contained are true. Fitness my hand of Notorial Seal this Q day of 201 Mir Commission -- Notary Public '; 1 ,4;x, /� i I