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Home My WebLink About221154 06/18/2013 CITY OF CARMEL, INDIANA VENDOR: 353845 Page 1 of 1 ONE CIVIC SQUARE MYERS CONSTRUCTION MGT INC CARMEL, INDIANA 46032 13518 MYRTLE LANE CHECK AMOUNT: $181,350.00 FISHERS IN 46038 CHECK NUMBER: 221154 CHECK DATE: 6/18/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 106 5023990 29569 1531 181, 350 . 00 FOUNDERS PARK SPORTS TM la.11--AIA Document G702 1992 JUN 9 4 13 Application and Certificate for Payment LJqy:, TO OWNER:Carmel/Clay Poe.I.ird of Parks& Recreation PROJECT:Founders Park Sports Field APPLICATION N0:2 Distribution to: 1411E. 116th Street Improvements Project PERIOD TO: 5/30/13 OWNER ❑ CarmeI, IN 46032 CONTRACT FOR: ARCHITECT ❑ General Construction FROM CONTRACTORMyers Construction Mgmt., Inc. VIA ARCHITECT:The Schneider Corporation CONTRACT DATE: 3/18/13 CONTRACTOR ❑ 13518 Myrtle Lane 8901 Otis Avenue PROJECT NOS: Fishers, IN 46038 Indianapolis, IN 46216 FIELD ❑ Invoice#1531 Job#506 OTHER ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information Application is made for payment,as shown below,in connection with the Contract. and belief the Work covered by this Application for Payment has been completed in accordance AIA Document G703T111,Continuation Sheet,is attached. with the Contract Documents, that all amounts have been paid by the Contractor for Work for which ,,_'7e�icates for Payment were issued and payments received from the Owner, and evio ch pre 1.ORIGINAL CONTRACT SUM...................................... 417,000.00 me s ........... $ thal.current, int powh rye, is now due r 11 2.NET CHANGE BY CHANGE ORDERS .:.,............................ 0.00 CON' I �r 1 oAn�a g e due. n�. 3.CONTRACT SUM TO DATE(Line 1 2) ............................... $ 417,000.00 By: TRACT Myer A Date:IV F Da 4.TOTAL COMPLETED&STORED TO DATE(Cohnnn G on G703) ...... $ 210 .590 no State of: 5.RETAINAGE: County of: 40,m1 1+Zw_1 SANDRA K. MYERS a. 10 %of Completed Work Notary Public. State of Indiana - Subscribed and sworn to before Hamilton County (Columns D+'E on G703) 21 05900 me this '60J A-- day of Commission#607059 b. in %of Stored Material My Commission Expires (Column F on G703) August 23, 2017 $ n no Notary Public: My commission expires: g-z Total Retainage(Lines 5a+5b, or Total in Column 1 of G703)...... $ 4(7159 00 -;5 -1 - 1 6.TOTAL EARNED LESS RETAINAGE .................................... $ 1_8aA6B_00_ ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 minus Line 5 Total) In accordance with the Contract Documents,based on on-site observations and the data comprising this application,the Architect certifies to the Owner that to the best of the Architect's knowledge, 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT ...................... $ 8,118-00 information and belief the Work has progressed as indicated, the quality of the Work is in (Line 6fi•oin prior Certificate) accordance with the Contract Documents, and the Contractor is entitled to payment of the 8.CURRENT PAYMENT DUE .............................................. 50.00 AMOUNT CERTIFIED. 9.BALANCE TO FINISH,INCLUDING RETAINAGE. AMOUNT CERTIFIED .........................................!.!........ . elf, ZJSD•00 .................. (Line 3 minus Line 6) 227,532.00 (Atta•h ewl3lananon if amount certified differ the ainoient applied. Initial allfigurew on this Application and on the Continuation Sheet that are changed to conform with the amount certified) CHANGE ORDER SUMMARY . ADDITIONS DEDUCTIONS ARCHIT T: Total changes approved in pre..vIOLIS months by Owner $ nn $ n nn By: Date: _sat Itas Total approved this month 0 00 0.0 0 This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractor TOTAL _o nn 0 on named herein:IssUafic61 payment and acceptance of payment are without prejudice to any rights of �E`f CHANGES by Change Order _0_00 the Owner or Contractor under this Contract. CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G702TI-1992.Copyright @ 1953,1963,1965,1971,1978, 1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA® Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. 010711AGD44 AI A Docun en#-_ G702 v 1992 Instructions-, Application and Certificate for"Payment GENERAL INFORMATION Purpose and Related Documents.AIA Documenf;G702T"-'?1992,Application and Certificate for Payment, is to be used in conjunction with AIA Document G703T111,,t ntinuation Sheet. These documents are designed to be used on a Project where a Contractor has a direct Agreement'with;the Owner. Procedures for their use are covered in AIA Document A201 TM,General Conditions of the Contract-for Construction. Use of Current Documents.Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions.This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AiA.There is no implied permission to reproduce this document, nor does membership in The American institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AiA. Rights to reproduce the document may vary for users of AiA software. Licensed AiA software users should consult the End User License Agreement(EULA). To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects' legal counsel,copyright @aia.org. COMPLETING G702 t After the Contractor has completed AIA Document G703, Continuation Sheet, summary information should be transferred to AiA Document G702,Application and Certificate for Payment. The Contractor should sign G702,have it notarized,and submit it,together with G703,to the Architect. The Architect should review G702 and G703 and, if they are acceptable, complete the Architect's Certificate for Payment on G702. The Architect may certify a different amount than that applied for, pursuant to Sections 9.5 and 9.6 of A201,. The Architect should then initial all figures on G702 and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G702 and G703 should be forwarded to the Owner. MAKING PAYMENT The Owner should make payment directly to the Contractor based on the amount certified by the Architect on AIA Document G702,Application and Certificate for Payment. The completed form contains the name and address of the Contractor. Payment should not be made to any other party unless specifically indicated on G702. EXECUTING THE DOCUMENT Persons executing the document should indicate the capacity in which they are acting(i.e., president, secretary, partner,etc.)and the authority under which they are executing the document. Where appropriate, a copy of the resolution authorizing the individual to act on behalf of the firm or entity should be attached. AIA Document G702TM—1992.Copyright @ 1953,1963,1965,1971,1978,1983 and 1992 by The American Institute of Architects.All rights reserved. WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this It AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. 010711ACD 4 e Myers Construction Management, Inc. Page: 2 AIA Continuation Sheet Application No.: 2 Application Date: 5/30/13 Period To: 5/30/13 Job: Founders Park Sports Field Improvements Project A B C D E F G H I Item Scheduled Work Completed Stored Total Comp. Percent Balance No. Description of Work Value Previous This Period Material &Stored Complete to Finish Retainage 1000 General Conditions 1 Supervision 11,000.00 0.00 4,500.00 0.00 4,500.00 41% 6,500.00 450.00 2 Performance& Payment Bond 8,000.00 8,000.00 0.00 0.00 8,000.00 100% 0.00 800.00 3 Builders Risk Insurance 1,020.00 1,020.00 0.00 0.00 1,020.00 100% 0.00 102.00 4 Maintenance Bond 1,500.00 0.00 0.00 0.00 0.00 0% 1,500.00 0.00 5 Misc. General Conditions 2,170.00 0.00 500.00 0.00 500.00 23% 1,670.00 50.00 6 Contingency Allowance 25,000.00 0.00 0.00 0.00 0.00 0% 25,000.00 0.00 2000 Site Work 1 Surveying 6,000.00 0.00 4,800.00 0.00 4,800.00 80% 1,200.00 480.00 2 Excavation 135,000.00 0.00 90,500.00 0.00 90,500.00 67% 44,500.00 9,050.00 3 Erosion Control 6,200.00 0.00 6,200.00 0.00 6,200.00 100% 0.00 620.00 4 Storm Sewer 58,000.00 0.00 55,000.00 0.00 55,000.00 95% 3,000.00 5,500.00 5 Sanitary Sewer 11,000.00 0.00 0.00 0.00 0.00 0% 11,000.00 0.00 6 Water Line& Meter Pit 5,000.00 0.00 0.00 0.00 0.00 0% 5,000.00 0.00 7 Concrete Sidewalks- Material 1,710.00 0.00 0.00 0.00 0.00 0% 1,710.00 0.00 8 Concrete Sidewalks- Labor 3,000.00 0.00 0.00 0.00 0.00 0% 3,000.00 0.00 9 Concrete Curbs 1,000.00 0.00 0.00 0.00 0.00 0% 1,000.00 0.00 10 Sundial Structures-Material 45,000.00 0.00 40,000.00 0.00 40,000.00 89% 5,000.00 4,000.00 11 Sundial Structures-Labor 6,800.00 0.00 0.00 0.00 0.00 0% 6,800.00 0.00 12 Foot Shower-Material 4,000.00 0.00 0.00 0.00 0.00 0% 4,000.00 0.00 13 Foot Shower- Labor 4,000.00 0.00 0.00 0.00 0.00 0% 4,000.00 0.00 14 Bench-Material 1,600.00 0.00 0.00 0.00 0.00 0% 1,600.00 0.00 15 Bench-Labor 300.00 0.00 0.00 0.00 0.00 0% 300.00 0.00 16 Landscaping 400.00 0.00 0.00 0.00 0.00 0% 400.00 0.00 17 Sports Field Seeding 15,300.00 0.00 0.00 0.00 0.00 0% 15,300.00 0.00 18 Prairie Seeding 12,000.00 0.00 0.00 0.00 0.00 0% 12,000.00 0.00 19 Irrigation 43,600.00 0.00 0.00 0.00 0.00 0% 43,600.00 0.00 3000 Concrete 1 Concrete Footings-Labor 3,000.00 0.00 0.00 0.00 0.00 0% 3,000.00 0.00 2 Concrete Footings-Material 3,000.00 0.00 0.00 0.00 0.00 0% 3,000.00 0.00 3 Rebar-Material 800.00 0.00 0.00 0.00 0.00 0% 800.00 0.00 7000 Thermal & Moisture 1 Caulking 1,600.00 0.00 0.00 0.00 0.00 0% 1,600.00 0.00 Total 417,000.00 9,020.00 201,500.00 0.00 210,520.00 50% 206,480.00 21,052.00 i� AFFIDAVIT AND WAIVER OF LIEN PARTIAL State of Indiana County of Hamilton, SS: Donald R. Myers being duly sworn states that he is the President of Myers Construction Management, Inc. having contracted with Carmel/Clay Board of Parks and Recreation to furnish certain materials and/or General Construction for a project known as Founders Park Sports Field Improvements Projects located in Carmel, IN and does further state on behalf of the aforementioned contractor/supplier: That there is due from the owner the sum of Dnehuv,sdyeJ eig N-one-NutsgyyA AyeekgrldreA�Iqy ct >d ��co —Dollars $ I8 I t 350,o0 ( ) r ceipt 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. 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 or material or both, 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 or material furnished to the undersigned for said project, and within the scope of affidavit and waiver. B P. le: President Y WITNESS MY HAND AND NOTORI L SEAL, This �30f�-day of N�a 2013. My Commission Expires: 8-23-17 Printed: Sandra K. Myers County of Residence: Hamilton j (6 SANDRA K. MYERS 4 Notary Public, State of Indiana N Hamilton County (A Commossion u 607056 My Commission Expires { August 23, 2017 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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 Purchase Order No. 353845 Myers Construction Mgmt., Inc. Date Due 13518 Myrtle Lane Fishers, IN 46038 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO # Amount 5/30/13 1531 Founders Pk Sports field improvement 29569 $ 181,350.00 Total $ 181,350.00 1 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 353845 Myers Construction Mgmt., Inc. 13518 Myrtle Lane Fishers, IN 46038 In Sum of$ $ 181,350.00 ON ACCOUNT OF APPROPRIATION FOR 106 Park Impact Fee Fund Board Members PO#or INVOICE NO. CCT#/TITLI AMOUNT Dept# 29569 1531 5023990 $ 181,350.00 1 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 13-Jun 2013 Signature $ 181,350.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund