Loading...
HomeMy WebLinkAboutSANTAROSSA MOSAIC & TILE CO.,- 001337- 11/18/2010 CARMEL REDEVELOPMENT COMMISSION 001337 Santarossa Mosaic& Tile Co., Check: 1337 2707 Roosevelt Avenue Date: 11/18/2010 Indianapolis, In 46218 Vendor: SANTARO1 Prior Invoice P.O. Num, Invoice Amt Balance Retention Discount Amt. Paid 10 57 111,101.54 111,101.54 0.00 0.00 111,101.54 Application 10 111,101.54 111,101.54 0.00 0.00 111,101.54 056 DESEC. Carmel Redevelopment Commission 0 013 3.7 30 West Main Street REGIONS P Suite 220 20-1 921/740 CARMEL / 4/5 7.,,c1 IN 46032 1337 DATE AMOUNT • • 11/18/2010 111,101.54 PAY • THE SUM OF ONE HUNDRED ELEVEN THOUSAND ONE HUNDRED ONE DOLLARS AND 54 CENTS TO THE ORDER OF Santarossa Mosaic & Tile Co., 2707 Roosevelt Avenue Indianapolis, In 46218 r M• �qEE 10� • '00L337ii' 1:0 740 14 2 1 31: DOB 7SOLLIloo CARMEL REDEVELOPMENT COMMISSION 001337 Santarossa Mosaic& Tile Co., Check: 1337 2707 Roosevelt Avenue Date: 11/18/2010 Indianapolis, In 46218 Vendor: SANTARO1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 10 57 111,101.54 111,101.54 0.00 0.00 111,101.54 Application 10 • 111,101.54 111,101.54 0.00 0.00 111,101.54 , 1' AR AT Document G702/CMarM - 1992 57 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER:Lcme( i ��rI t(vo11r sw IPROJECT: I l APPLICATION NO: I Q Distribution to one CIV IC MUaQe '1-Q}& antot2t . 205.510 PERIOD TO 02123110 OWNER ❑ Dem2i Indiana 4uo2 "� nn CONSTRUCTION MANAGER ❑ FROM CONTRACTOR:3 OSIVO D.MQ I � hit O VIA CONSTRUCTION MANAGER: CONTRACT DATE:t5I QIIQq ARCHITECT ❑ � y y n '. v��tu8 PROJECT NOS: IA-RA / / CONTRACTOR ❑ �1I8"1�aI VIA ARCHITECT: FIELD ❑ CONTRACT FOR:GQQIIle, I UJODP/J'rlt ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractors knowledge, information and Application is made for payment.as shown below, in connection with the Contract belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet.AIA Document 6703,is attached Contract Documents, that all amounts have been paid by the Contractor for N ork tor which previous PALO Certificates for Payment were d and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $.6A1a,450.00 payment shout h ow 1 2 Net change by Change Orders $ • DD CONT n Q y 3.CONTRACT SUM TO DATE(Line I ± •$ i 4 ' x.00 ) �' Date IN I251110 4 TOTAL COMPLETED&STORED TO DATE(Column G on 0703) $ 5 i iglu iu State of Iano Mai 5,RETAINAGE: County of V402JW a, To of Completed Work Subscribed an s o , to b fore (Column D+Eon G703) $ 42-A22.50 me this 2 ,� ,�, 1. I� i / b, . 'To of Stored Material Notary Publ c: (Column F on G703) $ My Commis io e. ptres: 12 I /l , Total Retainage(Lines 5a+56 or total in Column I of G703)., $ 41,322.50 CERTIFICA FOR PAYMENT a^t CC In accordance with the Contract Documents, based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ ym4t.D�� 0 t�`'t' this application, the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line a Total) 4-4-5 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 4%Z, .51) accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certiftca te) CERTIFIED. I I s4 8,CURRENT PAYMENT DUE S I I I I I(D I.54 AMOUNT CERTIFIED $ 1�l t I R5 ` 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs fro; amount applied. Initial all figures on tins 302,312 I . Application and a -Cwulmat:an Site hat t wtged to con form with the amount certified.) (Line 3 less Line 6) $ .g14 CONS - CTION kite �� I �7 J By: tL.� .-_r ere ' Date: �S/ZI fo CHANGI ORDER SUMMARY ADDITIONS DEDUCTIONS ARCH! ECT: P IF �y,ITotal changes approved in precious months by Owner $ $ Bs ® Date 0 V 3 0K/ Total approved this Month $ $ 'I'his Cenifica e is t "regotinble.e AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ $ named herein Iss ante.-p tcment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ the Owner or Contractor wider 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 G792/CMaTe—1992.Copyright m 1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlAe 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 len(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,a-mail The American Institute of Architects legal counsel,copyright @aia.org. 09201 CONTINUATION SHEET AIA DOCUMENT G703 (Instructions on reverse side) PAGE 2 GE AGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: 10 containing Contractor's signed Certification. is attached. APPLICATION DATE: 8/172010 In tabulations below, amounts are stated to the nearest dollar. • PERIOD TO: 8/23/2010 nI�� Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO.:a.luldQOS 1A5 5110 A B C D E F - G H I WORK COMPLETED MATERIALS TOTAL BALANCE ITEM SCHEDULED PRESENTLY COMPLETED � TO RETAINAGE NO DESCRIPTION OF WORK FROM PREVIOUS STORED AND STORED (IF VARIABLE) APPLICATION THIS PERIOD (NOT IN TO DATE (C + C) FINISH RATE) (D + E) D OR E) (D+F.+P) (C - G) 01.001 STONE FLOORING 01.100 MATERIAL 402,325.00 402,325.0( 402,325.00 100 38,515.10 01.201 LABOR 349,950.00 35,733.00 106,544.54 142,277.54 41 207,672.46 1,786.65 01.30 01.40 STONE TOPS 0150 MATERIAL 20,000.00 20,000.00 20,000.00 100 1,000.00 01.60 LABOR 28,000.00 14,065.00 14,065.00 50 13,935.00 703.25 01.70 01.80 QUARRY TILE 01.90 MATERIAL 1,500.00 1.500.00 02.00 LABOR 1,500.00 1,500.01 02.10 02.201 GENERAL ALLOWANCE 35,000.00 4,557.00 4,557.00 13 30.443.00 02.30( CAD AS-BUILT ALLOWANCE 5,000.00 5,000.00 03.401 BOND 3.175.00 3,175.0( 3,175.00 100 317.50 03.501 03.601 CHANGE ORDER#1 03.70( • • 846,450.00 475,298.00 111,101.54 586,399.54 69 260,050.46 42,322.50 AIA DOCUMENT 6703 • CONTINUATION SHEET FOR 0702 • 1992 EDITION • AIA • ©1992 • THE AMERICAN INSTITUTE OF ARCIIITEIIS, 1735 NEW YORK �` / AVENUE.NW,WASHINGTON,DC.200065292•WARNING:Unlicensed photocopying violates U.S.copydght laws and will subject the violator to legal prosecution. G703-1992 CAUTION:You should use an original AIA document which has this caution printed in red.An original assures that changes will not be obscured as may occur when documents are reproduced. WAIVER OF LIEN AND AFFIDAVIT ( ) FINAL (✓j PARTIAL ( PAYMENT TO FOLLOW i Ibdit i(t hUM being duly sworn states that(s) he is 1.0.0. of SANTAROSSA MOSAIC & TILE CO.. INC. having contracted with I { I 1' 1 het )L to furnish certain materials and/or labor as follows: �RQ(II4f U.O9L1. TIC for a project known as I 1 I located at jia), WOO and owned by�! JI� R 'IIQfl1erl� Of11M• does hereby further state on behalf of the aforementioned sub/contractor/supplier. PARTIAL WAIVER That the balance due from the contractor is the sum of: IhIAQeY11hl05011D141-1111aPed ki-E Iqb Q I211w DOLLARS ($ 13, 252 It (0 Receipt of which is hereby acknowledg d: or ( ) Payment of which has been promised as the sole consideration for this AFFIDAVIT AND WAIVER OF LIEN (PARTIAL) which is given to and for said amount effective upon receipt of such payment. FINAL WAIVER That the final balance due from the contractor is the sum of: DOLLARS ($ ) ( ) Receipt of which is hereby acknowledged: or ( ) Payment of which has been promised as the sole consideration Ibr this AFFIDAVIT AND WAIVER OF LIEN (FINAL) which is given to and for said amount effective upon receipt of such payment. THEREFORE: the undersigned waives and releases unto the said owner of said premises any and all lien or claim whatsoever on the above described property and improvements thereon on account of labor and.materialor both, furnished by the undersignedthereto, 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 this AFFIDAVIT and WAIVER. / _ J SANTAROSSA MOSAIC & TILE CO., INI. � —`—��• TITLE: D. Q . WITNESS my hand and notarial seal this day of µ641S- , 20 10 . • My Commission Expires: 12115 f IT � 1. � bIdL. °o�tat}_ Public i.Dye Residing in Marion, County of Indiana Printed WAIVER OF LIEN AND AFFIDAVIT ( ) FINAL / (v) PARTIAL ( ) PAYMENT TO FOLLOW I o] ld Kefdium being duly sworn states that(s) he is e.00 of SANTAROSSA MOSAIC & TILE CO.. INC. having contracted with �1 ' !.ti to furnish certain materials an or labor as follows: 4. . 1 � , QQt . for a project known as flmope, located at ,I f ff ILL ll. and owned b (t4 Je(elDpmonS WIMP() does hereby further state on behalf of the aforementioned sub/contractor/supplier. PARTIAL WAIVER That the balance due from the contractor is the sum of: • Oral tedkevenlhUU9,UDV FtUI edDin M0 t DOLLARS (S I I L Ici.54 ) ( ) Receipt of which is hereby acknowledged: or (b)"Payment of which has been promised as the sole consideration for this AFFIDAVIT AND WAIVER OF LIEN (PARTIAL) which is given to and for said amount effective upon receipt of such payment. FINAL WAIVER That the final balance due from the contractor is the sum of: DOLLARS (S ) ( ) Receipt of which is hereby acknowledged: or ( ) Payment of which has been promised as the sole consideration for this AFFIDAVIT AND WAIVER OF LIEN (FINAL) which is given to and for said amount effective upon receipt of such payment. THEREFORE: the undersigned waives and releases unto the said owner of said premises any and all lien or claim whatsoever on the above described property and improvements thereon on account.of.labor.and.materiaLor.both..furnished by the undersigned.thereto, 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 this AFFIDAVIT and WAIVER. -- - SANTARO SA MOSAIC & TILE CO.. I 13y`. TITLE: IL, 0. 0 . WITNESS my hand and notarial seal this 2 1r day of Ruc�US+ , 20 10 . My Commission Expires: I9. 15 l - ,� I . • L 14 /L N ry Residing in Marion. County of Indiana 1 a '.1 . Printed •