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HomeMy WebLinkAboutSIGNATURE CONSTRUCTION, LLC- 002847- 4/19/2012 CARMEL REDEVELOPMENT COMMISSION 00 28 47 Signature Construction, LLC Check: 2847 �f 720 3rd Ave., SW Date: 4/19/2012 Carmel, IN 46032 Vendor: SIGNATO1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 6-1a 709.89 709.89 0.00 0.00 709.89 LaFever site amenities 6-2a 8,819.69 8,819.69 0.00 0.00 8,819.69 P112 Veneer Motor Court 9,529.58 9,529.58 0.00 0.00 9,529.58 ry'aa',+ ,,','�.THE KEY TO DOCUMENT SECURITY F-iIHEAT PRINT IADDITIONAL'SECURITY FEATURES INCLUDEDT SEE BACK FOR DETAILS , K „5 7/S6D Z Carmel Redevelopment Commission -mss' ti-- 002847 ' ti 30 West Main Street A REGIONS Alt' Suite 220 % `20>ailnao �` `""t Carmel, IN 46032 ✓ } hTA1C ,- ..7‘' 2847 DATE AMOUNT i SJ 4/19/2012 9,529 58 PAY THE SUM OF NINE THOUSAND FIVE HUNDRED TWENTY NINE DOLLARS AND 58 CENTS • '• TO THE ORDER OF Signature;Construction, LLC „' 720 3rd Ave., SW_. Carmel, IN 46032 G • 11•00 284 711' 1:0 740 i4 2 L 3r: 0087 504 L L LH' CARMEL REDEVELOPMENT COMMISSION 002847 Signature Construction, LLC Check: 2847 720 3rd Ave., SW Date: 4/19/2012 Carmel, IN 46032 Vendor: SIGNATO1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 6-1a 709.89 709.89 0.00 0.00 709.89 LaFever site amenities 6-2a 8,819.69 8,819.69 0.00 0.00 8,819.69 ' P112 Veneer Motor Court 9,529.58 9,529.58 0.00 0.00 9,529.58 • i I 61I.52 COMPUTEREASE FORMS DIVISION(877)5n-5781 T-37228 ;'Z APPLICATION AND CERTIFICATION FOR PAYMENT .4/A DOCUMENT G702 PAGE ONE OF 2 PAGES 2 TO OWNER CRC at City of Cannel PROJECT: Site Amenities APPLICA'T'ION NO Invoice 4 6 Distribution to: Cannel Indiana 46032 Lafever Signature costs AOWN ER ARCHITECT - PEI2IOD TO: 03/25/2012 X CONTRACTOR I'ROM CONTRACTOR: VIA ARCHITECT: Pedcor Design Signature Construction Services LI.0 720 3rd Avenue S.W. PROJECT NOS: Carmel, Indiana 46032 CONTRACT FOR: CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's 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 6703,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 $ 28.290.00 2. Net change by Change Orders $ 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE(Line I=2) $ 28,290.00 / 4. TOTAL COMI'LE'fEURSTORGIJ'TO $ 27,850.26 y j/2t in...-. © �: � Date: 5. RETAINAGE: homas E. oontz,President i � 1IZ a. 0 %of Completed Work $ -0 Sub cribed and vorn to before me this 016 day of Arlo K (Column D+Eon 07031 ° LINDA G.BUCHANAN b. %of Stored Material $ :PsC`'`t kCotmry : .xm.q..._:, Fiancoc (Column F on G703) _ ux. : My Commission Expires Total Retainage(Lines 5a+5b or '''.,er::A„'= Au9USt 20,2019 Total in Column I of 6703) $ 0.00 ARCHITECT'S CERT ICATE FOR PAYM ''r- 6.6. 'TOTAL EARNED LESS RETAINAGE $ 27.850.26 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) $ 27,140.37 the quality of the Work is in accordance with the Contract Documents.and the Contractor 8. CURRENT PAYMENT DUE $ 709.89 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 439.74 _` `� (Line 3 less Line 6) AMOUNT CERTIFIED S (CCU CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amo nt certified differs from the amount applied.Initial all figures on this Total changes approved Application and ont/t nt Illation Sheet that are changed to co form with the amount certified.) in previous months by Owner ARCI IITI' • \\ \I Total approved this Month By: 1 W.t�l\ f Date: .6/h_ ���111 TOTALS S0.00 $0.00 This Certticate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contracto lamed nttirem.Issuance,payment ana acceptance 01 payment are without NET CHANGES by Change Order $0.00 prejudice to a 'gets of the Owner or Contractor under this Contract. AG DOCUMENT G702'APPLICATION AND CERTIFICATION FOR PAYMENT'1992 EDITION'AIA '01992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE..NW,WASHINGTON,DC 2000-5292 Users may obtain validation of this document by requesting a completed AIA Document D401 -Certifi n of Document's Authenticity from the Licensee. wa 3)Z9fl L SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Invoice # 6 3/25/12 P112 Site Amenities - Lefever Carmel , Indiana WORK COMPLETED _ MATERIALS TOTAL BALANCE ITEM DESCRIPTION OF SCHEDULED FROM PREVIOUS THIS PRESENTLY COMPLETED AND TO Committed NO. WORK VALUE APPLICATIONS PERIOD STORED STORED TO DATE % FINISH Cost General Requirements: Site Supervision 13,145.00 13,145.00 0.00 0.00 13,145.00 100% 0.00 13,145.00 Meetings 1,000.00 570.37 275.44 0.00 845.81 85% 154.19 845.81 Construction Management Fee 14,145.00 13,425.00 434.45 0.00 13,859.45 98% 285.55 13,859.45 28,290.00 27,140.37 709.89 0.00 27,850.26 98% 439.74 27,850.26 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 Site Amenities, 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 seven hundred nine dollars and eighty-nine cents ($790.89)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 _ r T omas . oontz, President Subscribed and sworn to before/m me this: ,26 maw,- ;°/1 Notary Public:, e. �yg,e.c.€ •u'.t^ .-.. LINDA G.BUCHANAN '..w::N .A: `: Hancock County a .;.,.I My Commission Expires `/'.7;54,1f August 20,2019 APPLICATION AND CERTIFICATION FOR PAYMENT AGI DOCUMEVT 6702 PAGE ONE OF 2 PAGES2 TO OWNER CRC at City of Cannel PROJECT: 1'112 Motor Coon APPLICATION NO Invoice a 6 Distribution to: - Cannel Indiana 46032 Veneer Signature costs OWNER ARCHITECT PERIOD TO: 03/25/2012 N CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design Signature Construction Services LLC 720 3rd Avenue S.W. PROJECT NOS: Camlel,Indiana 46032 CONTRACT FOR: CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's 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.AIA 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 S 49,100.00 2. Net change by Change Orders S 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE(Line 142) S 49,100.00 4. TOTAL COMPLETED R STORED TO S 39,16)90 /L L. //,- — H}': f ate: j 5. RETAINAGE: aria; oontz, 'rest ent / a. 0%of Completed Work 5 0 - hscribed an. worn to before me this c'lD day, mity.er...4 t Q (LTn I)+Eon 0703) b. %of Stored Material S — (Column F on 0703) 's%t`'.. LINDA G.BUCHANAN ;ti?-"M'`,'. % I otal Kenunage(Lines sa 4 an or wont Hancock County Total in Column l of G703) $ 0.00 ANCHI IEL I'S LEN I IFICA I t FUN PAYMtN I .Ee. 59 My Commission Expires * ,$d..' August 20,2019 6. TOTAL EARNED LESS RETAINAGE S 39,10.5.90 In accordance with the Contract Documents,based on on-site observations and the dart , , q (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) S 30,346.21 the quality of the Work is in accordance with the Contract Documents.and the Contractor 8. CURRENT PAYMENT DUE S 8,519,69 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH.INCLUDING RETAINAGE S 9,934.101 1 I �� (Line 3 less Line 6) . AMOUNT CERTIFIED $ I.HANId:ORDER SUMMARY AUDI IIUN, ULUUl HUNS (Attach explanation if amount Certified differs from the amount applied Initial all figures on this total changes approved Application and ondr emir tmti),Sheet that are[bonged to conform with the amount certified) in previous months by Owner ARCHITECT: 'total approved this Month Hy: a. n 1` Date: 3�)1Z 1� TOTALS $0.00 $0.00 This Certificate is dot ltegotiable. The AMOUNT'CERTIFIED is payable only t the I`\' Lona-actor k,��fereul.issuance,payment ano acceptance of payment a wamou NET CHANGES by Change Order 50.00 prejudice to any rights of the Owner or Contractor under this Contract. MA DOCUMENT G702'APPLICATION AND CERTIFICATION FOR PAYMENT'1992 EDITION'ALA 01992 THE AMERICAN INST,JdtE 0 RCHRECTS,1735 NEW YORK AVE.,NW.,WASHINGTON,DC 20006-5292 Users may obtain validation of this document by requesting a completed MA Document D401-Certification of Do" Authenticity from the Licensee. 3/Z1/17— SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Invoice # 6 3/25/12 P112 Motor Court Veneer - 12036 Carmel, Indiana WORK COMPLETED MATERIALS TOTAL BALANCE ITEM DESCRIPTION OF SCHEDULED FROM PREVIOUS THIS PRESENTLY COMPLETED AND TO Committed NO. WORK VALUE I APPLICATIONS PERIOD STORED STORED TO DATE 8 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 7,827.34 5,316.49 0.00 13,143.83 94% 906.17 13,143.83 CRC Meetings 1,000.00 322.37 0.00 0.00 322.37 32% 677.63 322.37 Construction Management Fee 10,500.00 8,595.00 0.00 0.00 8,595.00 82% 1,905.00 8,595.00 Construction Management Fee Alt 16 5 14,050.00 4.101.50 3,503.20 0.00 7,604.70 54% 6,445.30 7,604.70 49,100.00 30,346.21 8,819.69 0.00 39,165.90 I 80% 3,488.80 31,561.20 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 eight thousand eight hundred ninteen dolllars and sixty-nine cents ($8,819.69) 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 • T •mas %.ontz, Jr resi.ent Subscribed and sworn to before me this: G rch , 2 v/.2 Notary Public:��44 LINDA G.BUCHANAN 141;;rm`'° Hancock County so.L,'.' My Commission Expires a; '` August 20,2019 Prescribed by Slate Board of Accounts City Form 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 9 ac/.ri Co'ssfv>r7,1 to LL G Purchase Order No. 720 ?cc/ /�✓�� •r S.zU Terms Cu,^,77,-/, /'V AIGO3 Z Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 3 -2s-12 G h /Cot'r S, 3-2.5-11 G —Z 5/9o.44r(0.,}frvr4i.;47 -viiry -E (2 11/2 . /1,fa1('oa/7' r',?/9_ b)' is c C1 9 to q Total 9, 52 9. F I hereby certify that the attached invoice(s), or bill(s), is (are) true and corr.-e .nd I h d same in accor- dance with IC L5— 10-1.6. 20 I Cie]A-Treasurer