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Home My WebLink AboutSIGNATURE CONSTRUCTION, LLC- 207- 4/6/2011 Signature Construction, LLC Check: 207 720 3rd Ave., SW Date: 4/6/2011 Carmel, IN 46032 Vendor: SIGNAT01 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 4-19 40,123.92 40,123.92 0.00 0.00 40,123.92 App 19 on VOG parking garage 40,123.92 40,123.92 0.00 0.00 40,123.92 207 4/6/2011 **********40,123.92 THE SUM OF FORTY THOUSAND ONE HUNDRED TWENTY THREE DOLLARS AND 92 CENTS **** Signature Construction, LLC 720 3rd Ave., SW Carmel, IN 46032 Signature Construction, LLC Check: 207 720 3rd Ave., SW Date: 4/6/2011 Carmel, IN 46032 Vendor: SIGNAT01 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 4-19 40,123.92 40,123.92 0.00 0.00 40,123.92 App 19 on VOG parking garage 40,123.92 40,123.92 0.00 0.00 40,123.92 APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT 6702 PAGE ONE OF 2 PACES 2 '10 OWNER CRC at City of Carmel PROJECT: 70-3 VOG Parking Garage APPLICATIONNO Application 419 Distribution to • Application# 19 Signature costs OWNER Carmel Indiana 46032 'ARCHITECT PERIOD TO: 0If25/201i ! X CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design Signature Construction Services LLC 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 he st of the Contractor's knowledge, Application is made for payment,as shown below,in connection with the Contract int-rotation 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 horn the Owner,and that current payment shown herein is now due, 1. ORIGINAL CONTRACT SUM S 892,979.62 2- Net change by Change Orders 5 000 CONTRACTOR- 3- CONTRACT SUM TO DATE(Line I A 2) S 1•92,9 r9 o2 4. TOTAL COMPLETED&STORED TO $ sa404 37lS 5. RF,TAINAGFc By, bate'. //2 f I homes h ntz,President r i Jr a. 0°,e of Completed Work 5 0 Subscribed arid om to before me this day o[ .71l:u{ D(.' _�� oumn D+E bit 6703) ( ------ b. %of Stored Material $ )� ':?:' LIIJDA BUCHANAN 11 (Column F on 6703) 1 ql �'��^ Hancock County total Kc[amage(Lines 5a+Thor ! s SEA MMy Commission Expires Total in Column I of 6703) S 0,00 AKUF1E Etc l 's GER I IFIGA I E FUR HA MtN; ''Nu .44J,2091 6 TOTAL EARNED LESS otal) AGE $ 8 4,043:tS In accordance with the Contract Dncumrnrs,hosed on on-site observations and the data (Line 4 Less],inc 5 Total) comprising the application,the Architect certifies to the Owner that to the hest of the 7, LESS PREVIOUS CERTIFICATES FOR Architect's knowledge,infbnnation and belief the Work has progressed as indicated, PAYMENT(Line 6 From prior Certificate) S 81 3,919.S7 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE 5 40,12592 is entitled to payment of the AMOUNT CERTIFIED, 9. BALANCE TO FINISH.INCLUDING RETAINAGE S 38,93a 34 (Line 3 less Line 6) AMOUNT CERTIFIED .., .. $ 40 123 AZ_ LMAt Lrb URIF,A SUMMAKY AUDI Ile INS DEC00I IONS_ (Attach explanation if amount certified diflPrsf'om the amount applied lethal all figures on this I otal changes approved - Application and(snrhe Combination Sliced Thal are changed to conform with the amount certified) in previous months by Owncr _ ARCHITECT: 1 Total approved this Month Date f 2.[j 1 yI` TOTALS $000 50.00 This Certificat is not egoti hie. The AMOUNT CERTIFIED is payable only to the 1 ^�/ contraernr nam o'e In.issuance,payment ana acceptance w payment are wancur NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract- (5 AIA DOCUMENT 0702-APFLICATION AND CERTIFICATION FOR PAYMENT 1992 EDITION•AlA 01992 THE AMERICAN INSTITUTE OF ARCHITECTS 1755 NEW YORK AVE..N.W.WASHINGTON,DC 2000E-5292 �/ ,U4 Users may obtain validation of this document by requesting a completed AIA Document D401 -Certification of Document's Authenticity from the Licensee- yY 409 (3 SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Application # 19 1/25/11 7C-3 VOG Parking Garage Carmel , Indiana WORK COMPLETED MATERIALS TOTAL BALANCE ITEM DESCRIPTION OF SCHEDULED FROM PREVIOUS THIS PRESENTLY COMPLETED AND TO NO. WORT( VALUE APPLICATIONS PERIOD STORED STORED TO DATE % FINISH RETAINAGE 101 Pre-Construction Services 66,557.63 66,557.63 0.00 0.00 66,557.63 100% 0.00 0.00 100 General Requirements: Testing 6 Inspecting 59,422.00 46,185.37 0.00 0.00 46,185.37 78% 13,236.63 MOO Project Management 37,828.63 31,1.21.62 3,416.76 0.00 34,538.38 91% 3,290.25 0.00 Site Supervision 204,987.31 185,128.43 19,381.28 0.00 204,509.71 100% 477.60 0.00 Site Safety Director 10,894.00 5,898.43 823.20 0.00 6,721.63 62% 4,172 37 0.00 Design Drawings 3,255.96 2,258.12 11.00 0.00 2,269.12 70% 986.84 0.00 Temporary Electric 17,255.96 12,248.84 2,633.25 0.00 14,882.09 868 2,373.87 0.00 Temp Fire Protection 1,838.00 0.00 0.00 0.00 0.00 0% 1,838.00 0.00 Temp Lighting 426.60 175.39 9.00 0.00 175.39 41% 251.21 0.00 Temp Water 843.82 145.39 0.00 0.00 145.39 17% 698.43 0.00 Sanitary Facilities 497.00 40.04 0.00 0.00 40.04 8% 456.96 0.00 Field Office 12,746.00 12,645.86 0.00 0.00 12,645.86 99% 100.14 0.00 Temp Electric 2,451.00 2,451.19 0.00 0.00 2,451.19 100% (0.19) 0.00 Office Supplies 2,451.00 2,351.41 0.00 0.00 2,351.41 96% 99.59 0.00 Temp Phone 1,657.29 760.30 896,99 0.00 1,657.29 100% 0.00 0.00 Temp Water 490.00 157.45 0.00 0.00 157.45 32% 332.55 0.00 Tools 4 Equipment 19,610.00 19,444.49 0.00 0.00 19,444.49 99% 165.51 0.00 Temp Fence 1,634.00 739.13 0.00 0.00 734.13 45% 899.67 0.00 Project Signage 1,225.00 593.00 0.00 0.00 593.00 484 632.00 0.00 Field Eng Surveying 3,268.00 1,245.76 1,398.27 0.00 2,644.03 81% 623.97 0.00 Health & Safety 2,451.00 1,915.71 477.17 0.00 2,352.88 98% 58.12 0.00 Waste Disposal 10,725.23 10,576.85 0.00 0.00 10,576.85 99% 148.36 0.00 Egress Path 8,033.00 7,650.00 0.00 0.00 7,650.00 95% 383.00 0.00 Petro Test 6,850.00 6,850.00 0.00 0.00 6,850.00 100% 0.00 0.00 Signage 22,360.00 6,851.00 11,036.00 1.00 17,887.00 80% 4,473.00 0.00 Change Orders 5,075.00 2,403.97 0.00 0.00 2,403.97 0% 2,671.03 0A0 199 Construction Management Fee 358,146.19 387,529.49 50.00 0.00 387,579.48 100% 566.71 0.00 892,979.62 813,919.87 40,123. 92 1.00 854,043.76 96% 38,935.84 0.00 • CONDITIONAL AFFIDAVIT AND WAIVER OF LIEN STATE OF INDIANA ) COUNTY OF HAMILTOP) 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 Village on the Green Parcel 7c Parking Garage, 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 forty thousand one hundred twenty-three dollars and ninty-two cents ($40,123.92) 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, finished 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 / (ThomY , Koontz, President Subscribed and sworn to before me this:`YoLl o ac/1 0 Notary Public: e ke x.. - fl';w,i:�C; LINDA BUCHANAN i o Hancock county • .ry a My Commission Expires i "V August 20,2011