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