VERKLER CONSTRUCTION- 001329- 11/18/2010 CARMEL REDEVELOPMENT COMMISSION 001329
Verkler Construction Check: 1329
7240 Georgetown Road Date: 11/18/2010
Indianapolis, IN 46268 Vendor: VERKLER1
Prior
Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid
9 77,785.66 77,785.66 0.00 0.00 77,785.66
Work in August 2010 _
77,785.66 77,785.66 0.00 0.00 77,785.66
1ts6 CEr/cry Carmel Redevelopment Commission 001329
Et 30 West Main Street A. REGIONS
20.1421/740
Suite 220
tTP Y Carmel, IN 46032 .
1329
DATE . AMOUNT
11/18/2010 """"""77,785.66
PAY THE SUM OF SEVENTY SEVEN THOUSAND SEVEN HUNDRED EIGHTY FIVE DOLLARS,AND 66 CENTS
TO THE
ORDER
OF Verkler Construction
• 7240 Georgetown Road
Indianapolis, IN 46268 "
RE. ,,
e001329" 17.07401.42L31: 00875041L10
CARMEL REDEVELOPMENT COMMISSION 001329
Verkler Construction Check: 1329
7240 Georgetown Road Date: 11/18/2010
Indianapolis, IN 46268 Vendor: VERKLER1
Prior
Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Pak
9 77,785.66 77,785.66 0.00 0.00 77,785.6E
Work in August 2010 _
77,785.66 77,785.66 0.00 0.00 77,785.6E
APPLICATION AND CERTIFICATE FOR PAYMENT .
CONSTRUCTION MANAGER-ADVISER EDITION
AIA DOCUMENT G702/CAVIcr PAGE ONE OF PAGES
TO: City of Carmel Comm Develpnun Corp PROJECT: Village on the Green Office Building No. I. Carmel IN APPLICATION NO: 09 Distribution To:
Third Avenue S.W. PERIOD TO: 8/31/2010 DOWNER
Caramel, Indiana 46032 PROJECT NOS: 09-010 ❑ CONSTRUCTION
MANAGER
FROM: Verkler Incorporated CONTRACT DATE: 11/9/2009 ❑ARCHITECT
7240 Georgetown Road ❑ CONTRACTOR
Indianapolis, IN 46268 VIA CONSTRUCTION MANAGER:
CONTRACT FOR: Bid Item #1 VIA ARCHITECT: Pedcor Design Group LLC
The undersigned Contractor cenities that to the best of the Contractor's knowledge, Infor-
mation CONTRACTOR'S and belief the Work covered by this Application for Payment has been completed in
Application is made for payment. as shown below, in connection with the Contract. accordance with the Contract Documents, that all amounts have been paid by the
Continuation Sheet, AIA Document 6703, is attached. Contractor for Work for which previous Certificates for Payment were issued and payments
I. ORIGINAL CONTRACT SUM $ $807,500.00 received from the Owner.and that current payment shown herein is now due.
2. Net Change by Change Orders . $ $47,339.51
3. CONTRACT SUM TO DATE (Line I ±2) . $ $854,839.51 CUN I R`\C
4_ TOTAL COMPLETED & STORED TO DATE $ $813,529.51 Bv; .\`
Date: �{ �
I - •l D
(Column G on 6703)
RETAINAGE: State ot: Indiana
5. a. 10_00 V of Completed Work $ $81,352.95 County of: Marion
(Columns I) •F on(3703) Subscribed and sworn to befbre
h. 10.00%of Stored Material nie this 21st day of September,2(110
(Column F on G703) $ $0.00
Total Retainage(Line 5a+5b or rye'/ �, B
Total in Column I LESS RETAINAGE . S $81,352.95 �//Wt//1-4J 4/1-a t�L
6. TOTAL EARNED LESS RETAINAGE . S $732,176.56 Notary Public: Jancane Arbuckle
(Line 4 less Line 5 Total) My commission expires: March 2 2 13
LESS PREVIOUS CERTIFICATE FOR PAYMENT
. $ $654,390.90 CERTIFICATE FOR-PAYMENT
7.
8. CURRENT PAYMENT DUE $I, $77,785.66 In accordance with the Contract Documents, based on on-site observations and the data
y. BALANCE TO FINISH INCLUDING RETAINAGE comprising the application, the Construction Manager and Architect certifies to the Owner
that to the best of the their knowledge. information and belief the Work has progressed as
(Line 3 less Line 6) $122,662.95 indicated, the quality of the Work is in accordance with the Contract Documents, and the
Contractor is entitled to payment of the AMOUNT CERTIFIED.
AMOUNT CERTIFIED
$ 777g5-• 6 6
CI IANGE ORDER SUMMARY ADDITIONS DEDUCTIONS
(Ranch explanation if amount certified differs from the mnount applied for. Initial all
Total changes approved in figures on this Application and on the Continuation Sheet that are changed to co form to
the amount certified.)
previous months by Owner CONSTRUCTION MANAGER:
Total approved this Month $47,339.51 By: a_ Date:/0.41/a
ARCIII•IY.CP:
TOTALS $47.339.51 $0.00
13v: Date:
NET CHANGES by Change Order $47,339.51 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
31A DOCUMENT 6702/CMa•APPLICATION AND CIIR I IPICATION FOR PAYMENT•I•M2 EL/11'10N•AIA ,Clan:•TOE AMERICAN INS I I DI FE OE ARCI Iln!C I'S,1733 Saw YORK 1 O
:MINIM.N w,WA5NING1ON,De 201)lu.-£?'7•Users may obtain validation of this document by requesting a completed Ala Document D401-Certification of Document's Authenticity from the Licensee. 1
- G702/CMa-1992
CONTINUATION SHEET A/A DOCUMENT G703 PAGE 1 OF 5 PAGES
AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: 09
Contractor's signed Certification is attached. APPLICATION DATE:
In tabulations below, amounts are stated to the nearest dollar. TO:
Use Column I on contracts where variable retainage for line items may apply. CONTRACTOR'S PROJECT NO : 09-010
ARCHITECT'S PROJECT NO:
NET CHANGES by Change Order $47,339.51 I This Certificate is not negotiable. the AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance. payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
A1A DOCUMENT G702-APPI.ICA1ION AND CF.RTIFILV ION FOR PAYMENT•1992 EDITION•AlA •C1092•THE AMERICAN INSTITIJTE OF ARCHI'I'Fel'S.1735 NEW YORK
AVENUE,NW.,WASHINGTON,DC 20006A292•Users may obtain validation of this document by requesting a completed AIA Document D401-Certification of Document's Authenticity from the Licensee.
G702-1992
A B C D E F G H I
# Description of Scheduled Previous Work Work Presently Total % Balance to Total Retainage
Work Value Complete Completed from Stored Completed& Finish
This Period Stored to Date
General
Conditions
0001 Mobilization $15,000.00 $15,000.00 $0.00 $0.00 $15,000.00 100.00% $0.00 $1,500.00
0002 Performance $10,500.00 $10,500.00 $0.00 $0.00 $10,500.00 100.00% $0.00 $1,050.00
Bond
_0003 Safety $4,000.00 $4,000.00 $0.00 $0.00 $4,000.00 100.00% $0.00 $400.00
0004 Project $15,000.00 $15,000.00 $0.00 $0.00 $15,000.00 100.00% $0.00 $1,500.00
Superintendent
0005 Staking/Layout $3,000.00 $3,000.00 $0.00 $0.00 $3,000.00 100.00% $0.00 $300.00
General Subtotal: $47,500.00 $47,500.00 $0.00 $0.00 $47,500.00 100.00% $0.00 $4,750.00
Conditions
Bid Item#1 -
0006 Earthwork $10,000.00 $10,000.00 $0.00 $0.00 $10,000.00 100.00% $0.00 $1,000.00
Mobilization
0007 Excavation $20,000.00 $20,000.00 $0.00 $0.00 $20,000.00 100.00% $0.00 $2,000.00
0008 Demolition $7,000.00 $7,000.00 $0.00 $0.00 $7,000.00 100.00% $0.00 $700.00
0009 Build-Up Bldg $14,000.00 $14,000.00 $0.00 $0.00 $14,000.00 100.00% $0.00 $1,400.00
Pad
0010 Excavation for $10,000.00 $10,000.00 $0.00 $0.00 $10,000.00 100.00% $0.00 $1,000.00
Foundations
0011 Stone @ Bldg $6,000.00 $6,000.00 $0.00 $0.00 $6,000.00 100.00% $0.00 $600.00
Pad
0012 Prep for New $5,000.00 $0.00 $4,000.00 $0.00 $4,000.00 80.00% $1,000.00 S400.00
Walks
0013 Spreading of $4,500.00 $0.00 $0.00 $0.00 $0.00 0.00% $4,500.00 $0.00
Topsoil
0014 Remove Auger $17,000.00 $17,000.00 $0.00 $0.00 $17,000.00 100.00% $0.00 $1,700.00
Spoils
0015 Erosion Control $10,000.00 $10,000.00 $0.00 $0.00 $10,000.00 100.00% $0.00 $1,000.00
0016 Alt.#1 Water $10,000.00 $10,000.00 $0.00 $0.00 $10,000.00 100.00% $0.00 $1,000.00
Line
0017 Asphalt Paving- $5,000.00 $5,000.00 $0.00 $0.00 $5,000.00 100.00% $0.00 $500.00
CONTINUATION SHEET A/A DOCUMENT G703 PAGE 2 OF 5 PAGES
AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: 09
Contractor's signed Certification is attached. APPLICATION DATE:
In tabulations below, amounts are stated to the nearest dollar. TO:
Use Column I on contracts where variable retainage for line items may apply. CONTRACTOR'S PROJECT NO : 09-010
ARCHITECT'S PROJECT NO:
Mobilization
0018 Asphalt Paving - $7,500.00 $7,500.00 $0.00 $0.00 $7,500.00 100.00% $0.00 $750.00
Stone
0019 Asphalt Paving- $13,000.00 $13,000.00 $0.00 $0.00 $13,000.00 100.00% $0.00 $1,300.00
Binder
0020 Asphalt Paving- $10,000.00 $10,000.00 $0.00 $0.00 $10,000.00 100.00% $0.00 $1,000.00
Finish Coat
0021 Paving Marking $1,100.00 $1,100.00 $0.00 $0.00 $1,100.00 100.00% $0.00 $110.00
0022 Bollards-Mat'I $700.00 $0.00 $700.00 $0.00 $700.00 100.00% $0.00 $70.00
0023 Piling - $15,000.00 $15,000.00 $0.00 $0.00 $15,000.00 100.00% $0.00 $1,500.00
Mobilization
0024 Piling -Test $15,000.00 $15,000.00 $0.00 $0.00 $15,000.00 100.00% $0.00 $1,500.00
Piles
_0025 Piling $153,900.00 $153,900.00 $0.00 $0.00 $153,900.00 100.00% $0.00 $15,390.00
0026 Concrete $55,000.00 $55,000.00 $0.00 $0.00 $55,000.00 100.00% $0.00 $5,500.00
Reinforcement-
Mat'I
0027 Concrete $25,000.00 $25,000.00 $0.00 $0.00 $25,000.00 100.00% $0.00 $2,500.00
Reinforcement-
Labor
0028 Cast In Place- $13,000.00 $13,000.00 $0.00 $0.00 $13,000.00 100.00% $0.00 $1,300.00
Walls-Mat'I
0029 Cast In Place- $40,000.00 $40,000.00 $0.00 $0.00 $40,000.00 100.00% $0.00 $4,000.00
Walls- Labor
0030 Cast In Place- $5,000.00 $5,000.00 $0.00 $0.00 $5,000.00 100.00% S0.00 $500.00
SOG - Mat'l
0031 Cast In Place- $17,000.00 $17,000.00 $0.00 $0.00 $17,000.00 100.00% $0.00 $1,700.00
• SOG - Labor
0032 Cast In Place- $18,000.00 $18,000.00 $0.00 $0.00 $18,000.00 100.00% $0.00 $1,800.00
Elev Slabs-
Mat'l
0033 Cast In Place- $55,000.00 $55,000.00 $0.00 $0.00 $55,000.00 100.00% $0.00 $5,500.00
Elev Slabs-
Labor
0034 Misc. Concrete- $35,000.00 $35,000.00 $0.00 $0.00 $35,000.00 100.00% $0.00 $3,500.00
Mat'l
0035 Misc. Concrete- $35,000.00 $35,000.00 $0.00 $0.00 $35,000.00 100.00% $0.00 $3,500.00
Labor
0036 Site Concrete- $300.00 $0.00 $240.00 $0.00 $240.00 80.00% $60.00 $24.00
Mat'I
0037 Site Concrete- $16,500.00 $0.00 $8,250.00 $0.00 $8,250.00 50.00% $8,250.00 $825.00
Labor
-0038 Bitiminous $5,000.00 $5,000.00 $0.00 $0.00 $5,000.00 100.00% $0.00 $500.00
Dampproofng
_
0039 Bentonite $5,000.00 $5,000.00 $0.00 $0.00 $5,000.00 100.00% $0.00 $500.00
Waterproofing
CONTINUATION SHEET A/A DOCUMENT G703 PAGE 3 OF J PAGES
AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: 09
Contractor's signed Certification is attached. APPLICATION DATE:
In tabulations below, amounts are stated to the nearest dollar. TO:
Use Column I on contracts where variable retainage for line items may apply. CONTRACTOR'S PROJECT NO : 09-010
ARCHITECT'S PROJECT NO:
0040 Pedestrian $30,000.00 $0.00 $3,000.00 $0.00 $3,000.00 10.00% $27,000.00 $300.00
Traffic Coating
_0041 Joint Sealants $500.00 $0.00 $0.00 $0.00 $0.00 0.00% _$500.00 $0.00
Bid Item#1 Subtotal: $690,000.00 $632,500.00 $16,190.00 $0.00 $648,690.00 94.01% $41,310.00 $64,869.00
Allowances
0042 Winter $70,000.00 $47,101.00 $22,899.00 $0.00 $70,000.00 100.00% $0.00 $7,000.00
Conditions
Allowance
Allowances Subtotal: $70,000.00 $47,101.00 $22,899.00 $0.00 $70,000.00 100.00% $0.00 $7,000.00
Add for
sequencing of
Slab Pours/
Add for re-
routing Fire
Hydrant Line/
Add for
changing
sanitary sewer
pipe mat'l
0043 Add for $8,367.00 $0.00 $8,367.00 $0.00 $8,367.00 100.00% $0.00 $836.70
sequencing of
Slab Pours/
Add for re-
routing Fire
Hydrant Line/
Add for
changing
sanitary sewer
pipe mat'l
Add for Subtotal: $8,367.00 $0.00 $8,367.00 $0.00 $8,367.00 100.00% $0.00 $836.70
sequencing of
Slab Pours/
Add for re-
routing Fire
Hydrant Line/
Add for
changing
sanitary sewer
pipe mat'l
Add for PCO
#24/Add for
labor& marl on
Temporary
CONTINUATION SHEET A/A DOCUMENT G703 PAGE 4 OF 5 PAGES
AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: 09
Contractor's signed Certification is attached. APPLICATION DATE:
In tabulations below, amounts are stated to the nearest dollar. TO
Use Column I on contracts where variable retainage for line items may apply. CONTRACTOR'S PROJECT NO : 09-010
ARCHITECT'S PROJECT NO
Windows/Add
for PCO#26/
Add for
additional work
at Waterline
Tap
0044 Add for PCO $38,972.51 $0.00 $38,972.51 $0.00 $38,972.51 100.00% $0.00 $3,897.25
#24/Add for
labor&marl on
Temporary
Windows/Add
for PCO#26/
Add for
additional work
at Waterline
Tap
Add for PCO Subtotal: $38,972.51 $0.00 $38,972.51 $0.00 $38,972.51 100.00% $0.00 $3,897.25
#24/Add for
labor& marl on
Temporary
Windows/Add
for PCO#26/
Add for
additional work
at Waterline
Tap
GRAND TOTAL $854,839.51 $727,101.00 $86,428.51 $0.00 $813,529.51 95.17% $41,310.00 $81,352.95
APPLICATION FOR PAYMENT
PARTIAL WAIVER OF LIEN
Contractor: Verkler. Inc .
Address: 724(1 Genrgetown Rd.
Tnriignapnlfc TM 46268
Project Name and Address: Village en the Green Office Building No. 1
Period to: 8/31110
Job it: 1-06-1493
The Undersigned has been contracted by ftEi Construction, LLC as a Contractor in connection with construction
of the Project owned by Owner and located as indicated above.
The Undersigned, for and in consideration of any and all amounts paid to the Undersigned up to and including the
date of execution hereof and other good and valuable consideration, the receipt whereof is hereby acknowledged,
waives and releases any and all liens, notices of liens or of character, against, on or relating to or connected with the
above-described Project and improvements located thereon and related thereto, on account of labor or services,
materials, equipment, toots, machinery or apparatus furnished or leased, or which may be furnished or leased by, or
at the request of, the Undersigned for the Project. The Undersigned hereby warrants that the Project cannot be made
subject to any valid lien or claim by anyone who furnished or leased labor or services, materials, equipment, tools,
machinery or apparatus to, or at the request of, the Undersigned for use in the Project. This instrument, and the
waiver, release and representations hereunder, are for the benefit of, and may be relied upon by, the Owner, its
successors, assigns and mortgagees, the above-named General Contractor or Construction Manager, and any other
person by or through whom payments have been made to the Undersigned.
The undersigned, for and in consideration of the total payments in the sum of $ 77,785. 66
the receipt of which is hereby acknowledged, does hereby waive, release remise and relinquish any and all right to
claim any lien or liens for work done or materials furnished, or any kind or class of lien whatsoever for said building or
premises or project
Dated this 21st day of September, 2010
Verkler, Inc.
Company Nae
BY: II !/✓V TITLE: CE0/Treasurer
NAME: Fred 1 . Lusk
STATE OF Indiana
COUNTY OF Marion
Subscribed and sworn to before me, a Notary Public in and for said County and Stale, this 21st
day of September , 2010
•
My commission expires March 20, 2013 My county residence is Hamilton
Notary I �L(�f( L 1�r'Med Janeane Arbuckle