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HomeMy WebLinkAboutSMOCK FANSLER CORPORATION- 3- 9/29/2011 Smock Fansler Corporation Check: 3 2910 W Minnesota Street Date: 9/29/2011 Indianapolis, IN 46241-4541 Vendor: SMOCKFA1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 3 - Hanover Square 100 75,325.25 75,325.25 7,532.53 0.00 67,792.72 Hanover Square 3 (IPC - Merc) 4 - Hanover Square 100 21,646.50 21,646.50 2,164.65 0.00 19,481.85 Hanover Square 4 (IPC - Merc) 96,971.75 96,971.75 9,697.18 0.00 87,274.57 3 9/29/2011 *******'**87,274.57 THE SUM OF EIGHTY SEVEN THOUSAND TWO HUNDRED SEVENTY FOUR DOLLARS AND 57 CENTS "'km** Smock Fansler Corporation 2910 W Minnesota Street Indianapolis, IN 4624 1-454 1 Smock Fansler Corporation Check: 3 2910 W Minnesota Street Date: 9/29/2011 Indianapolis, IN 46241-4541 Vendor: SMOCKFA1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 3 - Hanover Square 100 75,325.25 75,325.25 7,532.53 0.00 67,792.72 Hanover Square 3 (IPC - Merc) 4 - Hanover Square 100 21,646.50 21,646.50 2,164.65 0.00 19,481.85 Hanover Square 4 (IPC - Merc) 96,971.75 96,971.75 9,697.18 0.00 87,274.57 AlA Type Document 9 Application and Certification for Payment Pane T of 2 TO(OWNER(:VILLAGE FINANCIAL LLC PROJECT'HANOVER SO FOUNT @ CITY CTR. APPLICATION NO: ' y—3 DISTRIBUTION 11°0 770 3RD AVENUE SW 770 3RD AVENUES W CARMEL.IN 46032 CARMEL,IN 43032 PERIOD TO:7031/2011 TO: OWNER _ARCHITECT _CONTRACTOR FROM(CONTRACTOR):Smock Fansler Corporation VIA/ARCHITECT', ARCHITECTS 2910W.Minnesota Street PROJECT NO. indianaoois.IN 46241 CONTRACT FOR: CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYM ENT The Undersigned Contractor certifies Thal to the best et the CArnkacicr s knowledge,insormarien and bettof the work covered by this application for Payment has been completed in accordance with the Application is made for Payment,as shown below,in corrneclion with the Contract. Contract Documents,that Ai amounts have bcrm paid by the Contractor for Work for which previous Contnualion Sheet,AIA Typo Document is attached. Cmfiilcates for Paymentwero issued and payments received tram the owner.end that current payment shown he�' ' 1.ORIGINAL CONTRACT 5U(4 . .... ...... .... ...$__ 331.50(101) 2.Net Change by Change-Orders S n.eo CONTRACTOR: Smock F 2910 W. 3.CONTRACT SUM TO DATE (Line I r cJ $ 33",.500.00 f`l - '+7 `2.5, 2 S 4.TOTAL COMPLETED AND STORED TO DATE S 270,942.75 5y. ._,f-I-��\, / �� T TV_FANSLER 5.ftETAfNAG€: State at IN 53.'1 a. _ 10,00_%of Completed Work - 5 27,094.28 County of: M0R6AN Mr b._ 1130%of Stored Malarial S 0.00 Subscribed and Swum to -7 2 /'/� (, -7-792 Total retainage(Line Se+art} $ 7709428 Notary public; ' My Com,mission Expires: 6.TOTAL EARNED LESS RETAFNAGE. .... .. .... $ 243.848.47 I (Line 4 less Line 5 Total) ARCHITECT'S 7,LESS PREVIOUS CERTIFICATES FOR PAYMENT In Accordance elth the Ct !Line 6 from prior ..... .... ..... .....S......S 173,055.75 prising the above appticaf knowledge,information a, a.CURRENT PAYMENT DUE g 07,792.72 is in accordance with the P.BALANCE TO FINISH, INCLUDING RETAINAGE AMOUNT CERTIFIED. (Line 2 less Line 6) S 87,651.53 AMOUNT CERTIFIED. .. .. ......... ...... .......... . a it; • •��i--• 'AlfaG'e,pfanalion ii, u•I certified(Mere from are anrorud acplfed.toil d all figures on(his CHANGE ORDER SUMMARY ADDITIONS I -DEDUCTIONS A t!caeio 1 and on 9 CO_pp often Sheet that are changed to condom,to the amount cedh'edJ Total @ranges approved In 't pros cus months by Owner ARCHITECT- LIA 0.00 0,ec -111- �R By: G�e1 Dale: Teal approved this Month C.00 0.00 This CP%tll:r'ni is nut n Ocilla The AMOUNT CERTIF''.CD is payable only In the Conaactor nemed herwp,Iq e.Payment and acceptance oh payment are without prejudice to any TOTALS 0.00 0.00 rights of the Ovfnercr Contractor under this Contract. NET CHANGES by Clwn9e Order 0.00 Cm.- e7' Z(as/• • AEA Type Document • APPI[cation and Certification for Payment Page 2 of 2 TO(OWNER):VILLAGE FINANCIAL LLC PROJECT;HANOVER SO FOUNT CITY CTR. APPLICATION NO: 3 DISTRJRUTION 770 3RD AVENUE SW 770 3RD AVENUE SW CARMEL.IN 46022 CARMEL,IN 46032 TO PERIOD T 7/31/2011 TO: ON • ARCHITECT CONTRACTOR - FROM(CONTRACTOR):Smock Fansier Corporation VIA(ARCHITECT): ARCHITECTS 2910 W.MInnesota Stets • PROJECT NO: Indianapolis,IN 45241 CONTRACT FOR: - CONTRACT DATE: SCHEDULE PREVIOUS COMPLETED STORED COMPLETED ITEM DESCRIPTION VALUE APPLICATIONS THIS PERIOD MATERIAL STORED oj_ BALANCE RETAINAGE • FOUNTAIN EQUIPMENT 181,785.00 163,606.50 18,178.50 0.00 151785.00 100.00 0.00 18178.50 2 PIPING/PUMP 71,215.00 28,48600 22,046.75 0.00 60,532.75 55.00 10,682.25 6,053.28 INSTALLATfCNTELEC 3 GARAGE IMPROVEMENTS 23,500.00 - 3.525.03 14,100.00 0.00 17,025.00 75.00 5,875.00 1,762,50 4 PAVING AND SURFACE 55,000.00 0.00 11,000.00 0.00 • 11000.0 20.00 44,000.00 1,100.00 EQUIPMENT REPORT TOTALS • 6331,500.00 $195,617.50 175,325.75 $0.00 $27094235 81.73 860,557.25 $27,094.28 • • AFFIDAVIT AND WAIVER OF LIEN [ ] Final [X] I'aitial [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 CORP. having contracted with: Village Financial LLC to furnish certain labor, materials, and/or services as follows: Misc. Construction for a project known as: SFC#11-023 Hanover Sq. Fountain u(�, Clay Ctr. 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: (567,792.721 Sixty Seven Thousand Seven Hundred Ninety Two Dollars and 72/100 [ ] receipt of which is hereby acknowledged;or [X] the payment of which has been promised as the sole consideration of this A(Gdavit and Partial Waiver of Lien which is given solely with respect to said amount,and which waiver shall be effective only upon receipt ofpayment thereof by the undersigned; (FINAL WAIVER)that the final balance due from the owner is the sum of(WOO) [ I receipt of which is hereby acknowledged;or [ ] the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of Lien which shalt become effective uponreceipt of such 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 `\J42 •��� ZY"4 _ Title CEO T.M.Fansler WITNESS MY HAND AND NOTARIAL SEAL,this 201° day of,July ,2011. - RY� [ ' co?pp , Melissa J.Bi p Notg9 ublic My commission expires_November 30, 2016 Residing in Morgan County JY*„ST�T ":x�!r,:.FO1 INO • SUBCONTRACTOR'S SWORN STATEMENT OF INDEBTNESS &WAIVER OF LIEN STATE OF INDIANA COUNTY OF HAMILTON T.M. Fansler Being duly sworn upon his/her oath disposes and says that 1. He/she is CEO (inserting sole proprietor, partner or corporate office held, as the case mayby), to Smock Fansler Corporation hereafter called the"Subcontractor". He/she is over the age of twenty one. He/she is authorized to make this affidavit on behalf of Subcontractor. 2. Subcontractor is the Fountain Subcontractor for the construction of the development known as Hanover Square Improvements located in Carmel(City), INDIANA(state),hereafter referred to as the'Development", pursuant to the contract between the Subcontractor and Village Financial,LLC, the Owner. 3. This affidavit is made for the express purpose of inducing Village Financial, LLC, to make payment to Subcontractor of the invoice submitted herewith for labor and materials furnished pursuant to said Contractor. Upon receipt of said payment the Subcontractor hereby waives any lien reights to which Subcontractor is entitled for labor or materials furnished for the development to the date hereof. 4. Subcontractor agrees that upon receipt of the payment amount described above, Subcontractor shall immediately execute in favor the Owner,the"Transfer of Title"document(attached as Exhibit A) for all labor and material furnished to the extent described above. 5. Listed below are all suppliers or other persons who either has furnished or might furnish the Subcontractor with materials, appliances, machinery, fixtures or furnishing placed upon or installed on the development. Mark(X)in the appropriate column for EACH supplier listed. Place an (X)in column. 1.) If a waiver of lien by supplier conditioned by payment of a specified amount is attached hereto. (In this case also show the amount owed the supplier). 2.) If a FULL(final)lien release has been signed and delivered to the General Contractor. 3.) If the initial delivery has not been made. Supplier List(Add list if necessary) Billed to Date Previously Paid Balance D Transport Inc $520.00 $0.00 $520.00 Harrington Industrial Plastic $5,397.06 $0.00 $5,397.06 Irving Materials Inc, $945.00 $0.00 $945.00 Jobsite Supply $558.50 $0.00 $0.00 Service Pipe Supply $2,081.59 $97.78 $1,983.81 Utterback Supply $159.46 $0.00 $169.46 White Cap Construction $94,00 $0.00 $0.00 HD Supply Waterworks LTD $309.55 $0.00 $309.55 Noblesville Landfill Inc. $210.00 $0.00 $210.00 Allied Wholesale Electric $286.32 $0.00 $286.32 Maxim Electric LLC $5,350.00 _ $0.00 $5,350.00 # 1 and 2 correspond to the same numbered choices on the waiver format. Village Financial, LLC is hereby authorized to make payment to each such unpaid creditor either directly or by check jointly payable to Subcontractor and such creditor,as Village Financial, LLC shall determine. 5. There are no bills, charges,costs or expenses for labor or material which could now or hereafter result in lien being filed against the Development or a claim being asserted against the General Contractor except the persons or business named in Paragraph 4 above. IN WITNESS WHERE OF, affiant has signed this document on behalf of the Subcontractor this 20th day of July ,2011 %l l" I r .M. Fansler CEO State of INDIANA County of MORGAN "",,iC3P" -` 0 Subscribed and sworn to before me, a Notary Public in and for said County and State, this ',. �— ';fig'lei 20th day of July , 2011. . ;�E,,kL Y� � �� 1 Y 4 - l.Z. 1r 9 7 (Notary Pu c .:,,Y716.:.. iN,:;g„ •.ra,aa�lt,.. My Commission Expires. November 30, 2016 Melissa J. Bishop (Print Name) Attachment A TRANSFER OF TITLE Smock Fansler Corporation (Contractor) transfers to Village Financial, LLC any and all right, title and/or interest that Contractor has in any labor and/or materials described in (i) that Affidavit of Waiver of Lien executed by the Contractor on July 20th , 2011, and (ii) in the "Amount of this Request" section of that "CONTRACTOR" _ By: _ "7"7, \.. ��— Printed: T.M. Fansler Title: CEO /oo AIA Type Document Vgf/o 93 Application and Certification for Payment Page I of 2 ' TO(OWNER):VILLAGE FINANCIAL LLC PROJECT:HANOVER SQ FOUNT CITY CTR. APPLICATION NO:♦ 5.51 DISTRIBUTION 770 3RD AVENUE SW 770 3R0 AVENUE SW PERIOD TO:Bf3112011 TO: CARMEL,IN 46032 CARMEL.IN 46032 _OWNER _ARCHITECT FROM(CONTRACTOR):Smock Fancier Corporation _CONTRACTOR VIA(ARCHITECT): ARCHITECT'S 2910 MlnnNs4 Street PROJECT NO: Indianapolis.IN 466 241 CONTRACT FOR: CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT The Undersigned Contractor canine! belief the work covered by this appl( Application is made for Payment,as shown,below,in connection with the Contract Contract Documents,that all amoun Continuation Sheet,ALA Type Document Is attached. Certificates for Payment were issue current payment shown herein is no /� 1.ORIGINAL CONTRACT SUM S 331500.00 I Kos S / 6 - - .c 2.Net Change by Change Orders 5 0.00 CONTRACTOR: Smock Fenster Ct V 2910 W.Minnesot 3.CONTRACT SUM TO DATE(line 1 +2) $ 331,500.00 S 4.TOTAL COMPLETED AND STORED TO DATE $ 292,589.25 By: ' " A \ e'� 2 / J 6211 1 • ddd��� 111 T.M.FANSLER I CEO 4 G l k S S.RETAINAGE: 0 1 • a. 10.00%of Completed Work $ 29,258.93 State of:IN /�/ County of:MORGAN Nei- �{'/1�/ b. 0.00%of Stored Material 5 0.00 Subscribed and Sworn to before mr •rte" Total relainage(Line 5a+Sb) S 29,258.93 Notary Pectic: ,... - , My Commission Expires: , 6.TOTAL EARNED LESS RETAINAGE S 263,330.32 (Line 4 less Line 5 Total) ARCHITECT'S CER 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT In Accordance with the Contract D (Line 6 from prior Certificate) $ 243,848.47 prising the above aoplicafion, they knowledge,Information and belief the Work has progressed as indicated,the quality of the work 8.CURRENT PAYMENT DUE S 19,481.85 is in accordance with the Contract Documents, and the Contractor is entitled to payment of the 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED. (Line 3 less 1Jro 6) 5 68,169.68 AMOUNT CERTIFIED $ 4U', SC CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation A amount certified differs from the amount applied.fide)act figums on this Application and on the Minn:ion Sheet that are changed to conform to the amount certified) Total changes approved In previous months by Owner ARCHITECT: to 0.00 0.00 t o� 6Y: 4�a �, Date: Bl[i7 It Total approved this Month 0.00 0.03 This Certih•- - ..t negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein.Issuance,Payment and acceptance of payment are without prejudice to any TOTALS 0.00 0.00 rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order 0.00 AFFIDAVIT AND WAIVER OF LIEN [ 1 Final [X] Partial [IX] Payment to Follow State of Indiana County of Marion T.M. Fansler , being duly sworn states that he is the CEO of SMOCK FANSLER CORP. having contracted with: Village Financial LLC to furnish certain labor, materials, and/or services as follows: Misc. Construction for a project known as: SFC011-023 Hanover Sq. Fountain (d Clay Ctr. 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: ($19,481.851 Nineteen Thousand Four Hundred Eighty One Dollars and S5/IUO [ ] receipt of which is hereby acknowledged;or (X] the payment of which has been promised asthe 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($0.001 [ ] receipt of which is hereby acknowledged;or [ ] the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of Lien which shall become effective uponreceipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises,any and all hen 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.s� � SMOCK FANSLER CORP. By �?'iA.#1/4/4„-LTitie CEO T.Mr WITNESS MY HAND AND NOTARIAL SEAL,this 19th day of Anaust,2011. f9y ptittt Melissa]. Bishop Notav Public '' My commission expires November 30, 2016 Residing in Morgan County SrArCOFtN�Or ,- • State of INDIANA County of MORGAN Subscribed and sworn to before me, a Notary Public in and for said County and State, this 19th day of August , 2011. 92 /14a-1-Nota Pub'/J!i Ir/ „ w u c;,ar.•, ry PUBCic::�.. My Commission Expires: November 30,2016 Melissa J. Bishop ` ` ' (Print Name) h " Attachment A irL � TRANSFER OF TITLE ••Pay. 4,1476 oF Smock Fansler Corporation (Contractor) transfers to Village Financial, LLC any and all right, title and/or interest that Contractor has in any labor and/or materials described in (I) that Affidavit of Waiver of Lien executed by the Contractor on August 19th , 2011, and (n) in the "Amount of this Request" section of that "CONTRACTOR" By: • / ' Printed: T.M. Fansler Title: CEO