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Home My WebLink AboutSMOCK FANSLER CORPORATION- 002985- 6/21/2012 CARMEL REDEVELOPMENT COMMISSION 002985 Sfiock Fansler Corporation Check: 2985 2910 W Minnesota Street Date: 6/21/2012 Indianapolis, IN 46241-4541 Vendor: SMOCKFA1 Prior Invoice P.O. Num, Invoice Amt Balance Retention Discount Amt. Paid 13-b 41,483.00 41,483.00 0.00 0.00 41,483.00 P112 pavers retention • 41,483.00 41,483.00 0.00 0.00 • 41,483.00 rTHEKEY TO DOCUMENT SECURITY,�HEAT,�ACTIVATEU THUMB PRWT.j;ZADDITIONAL;5ECl1RIT,Y FEATURES INCLUDED;��SEE BACK FOR DETAILS Ft'}.•'s�,p,+', toss's/N. Carmel Redevelopment Commission REGIONS 002985 7t 30 West Main Street 20 EGI Suite 220 'CARMEL Carmel, IN 46032 los TRIGS 2985 DATE AMOUNT 6/21/2012 """""41,483.00 PAY THE SUM OF FORTY ONE THOUSAND FOUR HUNDRED EIGHTY THREE DOLLARS AND NO CENTS TO THE ORDER OF Smock Fansler Corporation 2910 W Minnesota Street �•v; Indianapolis, IN 46241-4541 M 000298511' ':0740 LL. 2L31: 0087504LLLi1' AIA Type Document Application and Certification for Payment Page 1 of 2 TO(OWNER):CARMEL REPEVELOPMNT COMMISSION PROJECT:R 111 PAVERS APPLICATION NO: 13 DISTRIBUTION 30 W. MAIN ST. PERIOD 70:10/3112011 TO; CARMEL, IN 46032 /r A =OWNER (;_� ARCHITECT CONTRACTOR FROM (CONTRACTOR): Smock Fancier Corporation VIA (ARCHITECT): Or �/V ARCHITECT'S 2910 W.Minnesota Street 7, T l EO PROJECT NO: Indianapolis, IN 46241 Or CONTRACT FOR: �<Ol2 CONTRACT DATE: 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 with the Application is made for Payment,as shown below,in connection with the Contract, Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,A1A Type Document is attached- Certificates for Payment were issued and payments received from the owner,and that current payment shown herein is now due. 1.ORIGINAL CONTRACT SUM- . . . . . . . . . . .$ 805,860 00 �,‘.µluuuwliwrrrrrfrrrr�grs CONTRACTOR: Smock Fancier Corporation o7' 3zY PU t./C 2. Net Change by Change Orders $ 23,800.00 2910 W.Minnesota Street Indianapolis,1N 46241 ,..(31'.• 829,660.00 ------ 3.CONTRACT SUM TO DATE(Line 1 +2) $ h n / ` .,, 4.TOTAL COMPLETED AND STORED TO DATE $ 829,660.00 By: /,(� /i i,/p,/A/ Date: __A IAs4.�L T.M. FANSLER I CEO _ = = 5.RETAINAGE: State of IN .'- a. 0.00 %of Completed Work S 0.00 �j,� 6' - •'QP' County of MORGAN �-! Day of 't d�A7-OF%20��ir� b. 0.00%of Stored Material $ 0.00 Subscribed and Sworn to before methis y y ( // 0.00 Notary Public: .� L!/ Total retainage(Line 5a+sb) S /'Y� Pig, My Commission Expires I ) /WI/ /Q P A/" 6.TOTAL EARNED LESS RETAINAGE $• 829,650.00 (Line 4 less Line 5 Total) ARCHITECT'S CERTIFICATE FOR PAYMENT 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT In Accordance with the Contract Documents,based on on-site observations and the data com- 788,177.00 prising the above application, the Architect certifies to owner that to the best of the Architect's (Line 6 from prior Certificate) $ knowledge, information and belief the Work has progressed as indicated,the quality of the work B.CURRENT PAYMENT DUE __ _ " . . . . $ 41,483.00 is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. 9.BALANCE TO FINISH, INCLUDING RETAINAGE (Lire 3 less Line 6) $ 0.00 AMOUNT CERTIFIED. . . . .. . . . . . . . . . .. .. . . . $ (Attach explanation if a •unt certified differs from the amount applied. Initial all figures on this CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Application an.'. i ltinuatinn Sheet that are changed to conform to the amount certified.) previous t amonth approved by Owner 2:3,800.00 0,0Q ARCHITECT: , _��1 Date: Total a roved this Month 0.00 0.00 This Certificate is�not negotiable. The AMOUNT CERTIFIED is paya le ly to the Contractor PP named heieinn.Issuance, Payment and acceptance of payment are without prejudice to any TOTALS 23,800.00 0.001 rights of the OW er or Contractor under this Contract. NET CHANGES by Change Order 23,600.00 cm-, _ Gip If.1- ' AIA Type Document Application and Certification for Payment Page 2 of 2 TO(OWNER):CARMEL REDEVELOPMNT COMMISSION PROJECT: P. 111 PAVERS APPLICATION NO: 13 DISTRIBUTION 30 W.MAIN ST. TO: CARMEL, IN 46032 PERIOD TO:10/31/2011 _OWNER _ARCHITECT _CONTRACTOR FROM(CONTRACTOR):Smock Fansler Corporation VIA(ARCHITECT): ARCHITECT'S 2910 W.Minnesota Street PROJECT NO: Indianapolis, IN 46241 CONTRACT FOR: CONTRACT DATE: SCHEDULE PREVIOUS COMPLETED STORED COMPLETED ITEM DESCRIPTION VALUE APPLICATIONS THIS PERIOD MATERIAL STORED % BALANCE RETAINAGE 1 MOBILIZATION 10,000.00 10,000.00 0.00 0.00 10,000.00 100.00 0.00 0.00 2 FIELD ENGINEERING 10,000.00 10,000.00 0.00 0.00 10,000.00 100.00 0.00 0.00 3 ASPHALT BASE 165,400.00 165,400.00 0.00 0.00 165,400.00 100.00 0.00 0.00 4 UNIT PAVERS 620,460.00 620,460.00 0.00 0.00 620,460.00 100.00 0.00 0.00 5 CHANGE ORDER#1 10,300.00 10,300.00 0.00 0.00 10,300.00 100.00 0.00 0.00 6 CHANGE ORDER#2 13,500.00 13,500.00 0.00 0.00 13,500.00 100.00 0.00 0.00 REPORT TOTALS S829,660.00 $829,660.00 $0.00 $0.00 $829,660.00 100.00 $0.00 $0.00 AFFIDAVIT AND WAIVER OF LIEN [X] Final [ ] Partial [X] Payment to Follow State of Indiana County of Marion T.M. Fansler • being duly sworn states that he is the CEO of SMOCK FANSLER CORI'. having contracted with: Carmel Redevelopment Commission to furnish certain labor, materials, and/or services as follows: Misc. Construction for a project known as: SFC#111-081 P. 111 Pavers located at Carmel, IN and does hereby state on behalf of the aforementioned contractor: (PARTIAL WAIVER)that there is due from the owner the sum of: (50.0111 [ ] receipt of which is hereby acknowledged; or [ ] 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(S.41,483.00). Forty One Thousand Four Hundred Eighty Three Dollars and No/11111 [ ] receipt of which is hereby acknowledged;or [X] the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of Lien which shall become effective upon receipt ofsuch 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, Materials, and/or Services, 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, materials, or services furnished to the undersigned for said project, and within the scope of this affidavit and waiver. SMOCK FANSLER CORP. By .%,4j 4 4(_ Title CEO 1.M. Fansler WITNESS MY HAND AND NOTARIAL SEAL, this 19th day of October,2011. st0hil p rr rrroire ` ma�yy// S /��// -•.•c Melissa J. Bishop Notary 'uhlic _* SEAL My commission expires November 30, 2016 Residing in _Morgan_County% /STgron wNtDmPP\\ • -i Prescribed by Stale 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 SmojL1 /Fan5ler Purchase Order No. 2 t1/110 , /I n�^�/s€k S+. Terms 1 n11�d))� p ells, I /V 4/b2"II Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 10-31-11 13 1I■I r&vpcs \vnrk (re\-erkloni• Total 111.)14,91,°.'': c. I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have-au•' a- .me in accor- dance with IC 5-11-10-1.6. a {. Co –Zip , 20 I2 - ♦� - -Treasurer