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HomeMy WebLinkAboutSIGNATURE CONSTRUCTION, LLC- 003245- 10/18/2012 CARMEL REDEVELOPMENT COMMISSION 003245 Signature Construction, LLC Check: 3245 720 3rd Ave., SW Date: 10/18/2012 Carmel, IN 46032 Vendor: SIGNATO1 Prior Invoice p.0. Num. Invoice Amt Balance Retention Discount Amt. Paid 46 746.76 746.76 0.00 0.00 746.76 Motor Court West wall 86 2,521.00 2,521.00 0.00 0.00 2,521.00 App 8B on P112 Motor Court 3,267.76 3,267.76 0.00 0.00 3,267.76 +.-`THE KEY:TDDOCUMENTLSECURI_T siEEATLCTIVATED_LTHUMB PRINT ADDITIONALISECURITY,FEATURES INCLUDEDZSEE BACK FOR DETAILS l q„ 1-;0 Of=%t Carmel Redevelopment Commission 003245 ixt 30 West Main Street L� REGIONS 1(740 Suite 220 zo-uzlnao °""'`�Carmel, IN 46032 O7fTRl�t 3245 DATE AMOUNT 10/18/2012 3,267.76 PAY THE SUM OF THREE THOUSAND TWO HUNDRED SIXTY SEVEN DOLLARS AND 76 CENTS "•''**** TO THE ORDER OF Signature Construction, LLC 720 3rd Ave., SW Carmel, IN 46032 ,°` M ` c " 0 3 2 1. 5" 1:0 740 14 2 131: 008750'. 1 1 Li" CARMEL REDEVELOPMENT COMMISSION 003245 Signature Construction, LLC Check: 3245 720 3rd Ave., SW Date: 10/18/2012 Carmel, IN 46032 Vendor: SIGNATO1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt, Paid 46 746.76 746.76 0.00 0.00 746.76 Motor Court West wall 3B 2,521.00 2,521.00 0.00 0.00 2,521.00 App 8B on P112 Motor Court 3,267.76 3,267.76 0.00 0.00 3,267.76 :-11.52 COMPUTEREASE FORMS DIVISION(877)577"5791 T-71771 . La APPLICATION AND CERTIFICATION FOR PAYMENT ifl-f DOCUAMENT 6702 PAGE ONE OF 2 PAGES 2 TO OWNER CRC at City of Carmel PROJECT: P 112 Motor Conn APPLICATION NO Invoiced 8 g Distribution to: Carmel Indiana 46032 veneer Signature costs [ OWNER ARCI IFrEcT PERIOD'I'O: 7/25/2012 ©CON'T'RACTOR FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design Signature Construction Services EEC 720 3rd Avenue S.W. PROJECT NOS: Cannel, Indiana 46032 CONTRACT FOR: CON'T'RACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractors knowledge, Application is made for payment-as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been Continuation Sheet,AlA Document 0703,is attached. 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. I. ORIGINAL CONTRACT SUM $ 48,650.00 2. Net change by Change Orders S 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE(Line I*2) $ 48,6ao.00 4. TOTAL COMPLETED&STORED TO $ 48.6•4.u0 7 74' /y By: Dale: 5. RETAINAGE: Thomas Ey ntr,President ,••;iii LINDA G.BUCHANAN a. 0%or-Completed Work $ 0 Subscribed and sw m to before me this 9' day of V u/� ,J 0I r?(p„4?'`:, HynWdC County Tcorn D+E on 0703) ,r. we. My Commission Expires h. %of Stored Material S -'?:i.. .., (Column F on 0703) _ AugU5129,2019_ Total Ketamage(Lines>a+>b or "° Total in Column)of G703) $ 0.00 ARCM FEG I'5 GERFIFIGA I E FOR PAYMENT 6. TOTAL EARNED I-IiSS RETAINAGE Si 48,65U.UU In accordance with the Contract Documents,based on on-site observations and the data (Line 4 Less Line 5 Total) comprising the application,the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge,information and belief the Work has progressed as indicated, PAYMENT(Line 6 from prior Certificate) $ 46,129.00 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE S 2,)2l mu is entitled to payment of the AMOUNT CER'T'IFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE S 0,00 , (Line 3 less Line 6) AMOUNT CERTIFIED $ 2 2 MAN W:l/KUEK SUMAIAKI AUDITIONS UhUUCIIONS ('Altar),explanation rfamuartt rerfifledd ers from the amount applied.Initial all fteures on this I oral changes approved Application and n et niinpalia Sheet that are changed to conform wills the amount cert fed) in previous months by Owner ARCIII'FECT: Total approved this Month By: ri.., • Date: "''7Jr-,ll'L '1OTAI.S $0.00 $0.00 This Certificate is not n eotiablc. The AMOUNT'CER'T'IFIED is payable o N to e contractor n�mea admit Issuance,payment am acceptance or payment are wnno t NET CHANGES by Change Order $0.00 prejudice to an rights of the Owner or Contractor under this Contract. AU DOCUMENT 6702'APPLICATION AND CERTIFICATION FOR PAYMENT'1992 EDITION'AlA'01992 THE AMERICAN INSTI F ARCHITECTS,1735 NEW YORK AVE..N W„WASHINGTON.DC 20WE•292 Users may obtain validation of this document by requesting a completed AIA Document D401 -Certific it'd of oc is Authenticity from the Licensee. la.... 7/ `Z SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Invoice # 8 7/25/12 P112 Motor Court Veneer - 12036 Carmel, Indiana WORK COMPLETED MATERIALS TOTAL BALANCE ITEM DESCRIPTION OF I SCHEDULED FROM PREVIOUS THIS PRESENTLY COMPLETED AND TO Committed _ . WORK VALUE APPLICATIONS PERIOD STORED STORED TO DATE % FINISH Cost General Requirements: Site Supervision 9,500.00 9,500.00 0.00 0.00 9,500.00 100% 0.00 9,500.00 Site Supervision Alt 1 6 5 14,050.00 14,050.00 0.00 0.00 14,050.00 100% 0.00 14,050.00 CRC Meetings 1,000.00 1,000.00 0.00 0.00 1,000.00 100% 0.00 1,000.00 Construction Management Fee 10,500.00 10,500.00 0.00 0.00 10,500.00 100% 0.00 10,500.00 Construction Management Fee Alt 16 5 13,600.00 11,079.00 2,521.00 0.00 13,600.00 100% 0.00 13,600.00 48,650.00 46,129.00 2,521.00 0.00 48,650.00 100% 0.00 48,650.00 • CONDITIONAL AFFIDAVIT AND WAIVER OF LIEN STATE OF INDIANA COUNTY OF HAMILTON ) Thomas E. Koontz being duly sworn states that he is the President of Signature Construction, LLC having contract to furnish certain materials and /or labor as follows: Construction Management Services for a project known as P112 Motor Court Veneer, located at Carmel, Indiana and owned by the Carmel Redevelopment Commission and does state: CONDITIONAL WAIVER: that the balance due from the owner is the sum of two thousand five hundred twenty-one dolllars ($2,521.00) the payment of which has been promised as the sole consideration for this Affidavit and Conditional Waiver of Lien which is given to and for said amount, effective upon receipt of such cash payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises any and all line or claim whatsoever on the above-described property and improvements thereon on account of labor or material or both, furnished by the undersigned thereto, and further certifies that no other party has any claim or right to a lien on account of any work perform or material furnished to the undersigned for the said project, and within the scope of this affidavit and waiver. SIGNATURE CONSTRUCTION, LLC / f omas y'oontz, President Subscribed and sworn to before me this: 5u 4 Cr" PI Notary Public: er, ,[r LINDA G.BUCHANAN in',•n5 Hancock County SEAL 4.1 My Commission Expires ?9,�..... August 20,2019 `� ig at re onstruction, LLC Carmel Redevelopment Commission Parcel 5 , P112, Motor Court Veneer 702 South Rangeline Road Carmel, IN 46032 ATTN: Mike Lee INVOICE Date: July 9, 2012 Invoice: 00048 Motor Court West Wall Hollow metal door south of transformer farm - $374.50 Black paint at west wall openings - $372.26 pL TOTAL INVOICE $ 746.76 Please make check payable to: Signature Construction, LLC If you have questions, please contact Jason Springer at 317-945-7915. CHISHOLM LUMBER & SUPPLY CO., INC. REMIT TO: 3419 Roosevelt Avenue CHISHOLM LUMBER&SUPPLY CO. liPallirlinFrill P.O. Box 18280 P.O. BOX 18280 INDIANAPOLIS,IN 46218 Indianapolis, Indiana 46218 LUMBER-MILLWORK-BUILDING MATERIALS Phone: (317) 547-3535 Fax: (317) 547-3537 www.chisholmmillwork.com SOLD TO SHIP TO Signature Construction, LLC Signature Construction, LLC 720 3rd Ave 11 W. CITY CENTER DR Carmel, IN 46032 Carmel, IN 46032 SUB: 99999 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Shipment # : 1 i$;,i.a R'}'"$4`°F 3, e Snie3Na ge „ C E.v :ze3 t At reW i 2 1,V r Fw iStM.`:4 r .4YR r awYk4:1 ;Ah. fl i s ✓, ± THE SHERWIN-WILLIAMS CO. /7. SHERWIN-WILLIAMS. 831 S RANGE LINE RD STE 1HL CARMEL IN 46032 2539 1 Visit www.sherwin-williams.com CHARGE Store 31 )843-1088 • INVOICE ACCOUNT:6765-9218-1 No. 4677-9 JOB 01 SIGNATURE CONSTRUCTION LLC PAGE 1 OF 1 POa ORDER:0E015689501122 DATE:06/14/2012 TIME:2:29 PM SIGNATURE CONSTRUCTION LLC 2-0100 - 720 3RD AVE SW E82I12099 • CARMEL IN 46032 2036 (317)817-0360 •INDICATES SALE PRICE TERMS NET PAYMENT DUE ON JULY 20TH SALES NUMBER SIZE PRODUCT DESCRIPTION QTY PRICE VALUE 6403-99705 5 GAL A6T154 A100 LTX FL ULTRA 5 35.09 175.45 COLOR SW6258 TRICORN BLACK CCE COLOR CAST OZ 32 64 128 81 BLACK 34 33 - 1 N1 RAW UMBER 14 24 1 - R2 MAROON - 3 1 1 SHER-COLOR FORMULA 180-9102 EACH 140755648 PURDY 4-8'POLE 2 24.99 ' 49.98 6502-78252 EACH ADJUSTABLE FRAME 2 28.79 57.56 145-2440 EACH SHWOO4 9X12.4MIL DROP 1 1.19 1.19 145-2432 EACH SHW001 9X12 1MIL DROP 2 2.99 5.98 173-1710 9 INCH 10171090 CS SOFT WOVEN CVR 1 5.79 5.7S 171-5135 9 INCH 105160900 HEAVY DUTY PRO FRAME 2 5.29 10.58 171-3825 3 INCH 10044330 3"CS ANG SASH LATEX 1 13.79 13.79 180-3386 18 IN 10338618 SW CS 18"X 112" 2 10.89 21.78 173-1710 9 INCH 10171090 CS SOFT WOVEN CVR 1 5.79 5,79 Thank You SUBTOTAL 347.91 receipt required for refund CHARGE ALES TAX:1.154603200 $372.26 MERCHANDISE RECEIVED IN GOOD ORDER BY: TIM REC'D JUN 1 Z(112 • Prescribed by State Board of Accounts City Forth No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER 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 S n..71eAf Coj,:iliia . Purchase Order No. 720 ?K0 61v. S Kc/ Terms Cnr�/ /�J hGG'32 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 7/2s// 83 ('//z 1ia7,--a, co--y74 /7 4? ' 2,S7,2(-GV Total 2,52/n00 I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor- dance with IC 5-11-10-1.6. , 20 Clerk-Treasurer Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.19951 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 c 7 4,#(:)c7:) LLC Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 7 ia y /Idray r0ui- 1:6,57t/ge// , 7Y6-6 Total 796 7, I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor- dance with IC 5-11-10-1.6. (o -le , 20 l7-- -Treasurer