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Home My WebLink AboutSIDNEY ELECTRIC- 185- 3/16/2011 Sidney Electric Check: 185 Date: 3/16/2011 Vendor: SIDNEYE Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 9 2,702.70 2,702.70 0.00 0.00 2,702.70 App 9 on Parking Structure 2,702.70 2,702.70 0.00 0.00 2,702.70 185 3/16/2011 2,702.70 THE SUM OF TWO THOUSAND SEVEN HUNDRED TWO DOLLARS AND 70 CENTS*"**"*"'m****** Sidney Electric Sidney Electric Check: 185 Date: 3/16/2011 Vendor: SIDNEYE Prior invoice P.O. Num, Invoice Amt Balance Retention Discount Amt. Paid 9 2,702.70 2,702.70 0.00 0.00 2,702.70 App 9 on Parking Structure 2,702.70 2,702.70 0.00 0.00 2,702.70 APPLICATION AND CERTIFICATION FOR PAYMENT AM DOCUMENT G702 PAGE ONE OF TWO PAGE(S) TO OWNER: PROJECT: APPLICATION NO 9 Distribution to: Carmel Garage Development Company Garage/Parking Structure Parcel 7C-3 - PERIOD TO: thru 12-31-10 OWNER FROM CONTRACTOR: VIA ARCHITECT: ARCHITECT Sidney Electric Co. Signature Construction ®CONTRACTOR 840 S. Vandemark Rd.,Sidney,OH 45365 Construction Mngr PROJECT NOS: 4460913/12011 CONTRACT FOR: Electrical CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractorcenil ics that to the best of the Contractors knowledge, Application is made for payment,as shown below,In connection with the Contract, information and belief the Work covered by this Application for Payment has been Continuation Sheet,AIA Document 6703,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 SEE ATTACHED SWORN STATEMENt'FROM CONT'RAC'TOR TO OWNER payments received from the Owner,and that cunent payment shown herein is now due. I. ORIGINAL CONTRACT SUM $ 465,900.00 2. Net change by Change Orders $ 102,235.00 CON'T'RACTOR: Sidney Electric Co. 3. CONTRACT SUM TO DATE(Line 1 1 2) $ 568,135.00 _ 4. 't'O'VAL COMPLETED&STORED TO S 5572.815.00 `�J DA'Z'E (Column G on G703) By �/2 -_ Date: 12.10.10 5. RETAINAGE:(Original Contract Only) :-Y ' rrrttt a, lU °/9 of Completed Work $ 57,281.50 State of Ohio � °,t�„� ty of Shelby (Column D+Eon 0703) Subscribed and s$e to before me thi>`:4,01(iii}dj ecember,2 l SAN R. MATER b. 10 %of Stored Material S 0.00 Notary Public: g =+/.=;6,r",+ (Column F on 0703) My Commission expires: (', -1' Notary Public,State of Ohio Total Rctainnge(Lines 5u+5h or v` It 1¢ Commission Expires June 4,2011 Total in Column l of 6703) $ 57,281.50 ARCHITECT'S CERTINEA FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 515,533.50 In accordance with the Contract Documents,based on on-site observations and the data (Line 4 Less Line 5 Total) comprising the application,the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge,information and belief the Work has progressed as indicated, PAYMENT(Line 6 from prior Certificate) S 512,830.80 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE S 2,702.70 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING REI'AINAUE $ 52,601,50 (Line 3 less Line 6) AMOUNT CERTIFIED $ 2,702.70 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount certified differafrnm the amount applied.Initial all figures on Ihie 'Total changes approved Application and onrhe Conrinsatinn Sheet that are changed to conform wish the amount certified,) in previous months by Owner $107.875.00 (S5,640,00) "ERR&?ItPPEt_ 1 ��sr r e.-- / Total approved this Month(U I) $0.00 $0.00 By:. „� ,J `T�J' Date: //I1` �( TOTALS $ 107.875.00 (55,640.00) This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein.Issuance,payment and acceptance or payment are without NET CHANCES by Change Order S 107,875.00 ($5,640.00) prejudice to any rights of the Owner or Contractor under this Contract, AIA DOCUMENT G702 APPLICATION ARO CERTIFICATION FOR PAYMENT'1002 EDITION ALA 01992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.NW,WASHINGTON,DC 2aa04-5292 el' CONTRACTORS APPLICATION FOR PAYMENT DETAIL GARAGE/PARKING STRUCTURE Page #1 CONTRACTOR SIDNEY ELECTRIC CO City Contract Number 4480913 OWNER'S NAME' SIGNATURE CONSTRUCTION Signature Consbucton Contract Number 12011 PROJECT NAME VILLAGE ON THE GREEN-GARAGE/PARKING STRUCTURE PARCEL 7C-3 Application Number 9 Application Dole: 12/1317010 Apoll#ation Period A B C D I E G H Work Completed Item Description of Work Scheduled Previous This Stored Total % Balance No Value Application Period This Period Completed p (F/C) To Finish 1 Submittals $ 5,000 $ 5,000.00 • S - $ 5,000.00 100% - 2 Bond/Insurance $ 8,000 S 8,000.00 - $ - $ 8,000.00 100% 3 General Conditors $ 15,000 S 15,000.00 - $ - 5 15,000,00 100% • 4 Temporary Power 5 18,932 $ 16,93200 - $ - $ 16,932.00 100% • 5 Dialdbuton Equipment-Labor S 5,145 S 5,145.00 - S - S 5,14600 100% - 6 Dolnbulion Equipment'Material $ 39,312 34,312.00 - $ - 5 34,312.00 100% • 7 Generator/Transfer Switch Equipment-Labor 5 2,315 2,315.00 - $ - S 2.315.00 100% - 8 Generaloraransler Switch Equipmen t-Material $ 117,030 117,030.00 - $ - $ 117,030.00 100% - 9 ' lighting System-Labor $ 6250 8,800.00 $ - 5 8,800.00 95% 400 10 Lighting System•Material $ 37,000 37,000.00 - $ - $ 37,00400 100% • 11 Grounding-Labor $ 500 . 500.00 • $ - $ 500.00 100% . 12 Grounding-Material S 400 400.00 - S - 5 400.00 100% - 13 Feeder Conduit Installation-Labor 5 13,500 15,500.00 - $ • S 13,500.00 100% • 14 Feeder Conduit Installaton-Malarial $ 13,700 13,700.00 - $ - $ 13,700.00 100% - 15 Branch Conduit Installation-Labor S 43,938 43,938.00 - 5 - $ 43.93e 00 100% - 18 Branch Conduit Instolleudn-Maternal $ 10,381 10,381.00 - $ - $ 10,381.00 100% • 17 Fader Wire and Cable Installation-Labor S 10,547 10,847.00 - Si - $ 10,847,00 100% - 18 Feeder Wm and Cable Inslallabon-Material $ 33,721 33,721.00 - $ - $ 33,721.00 100% 19 Branch Wire and Cable lnslaliation-Labor $ 13,582 13,582.00 - 5 - 5 13,582.00 100% - 2C Branch Wire end Cable lnataliabon-Material S 7,318 7,318.00 - 5 - $ 7,318,00 100% • 21 Wiring Device-Labor 5 3,087 $ 3,08700 - S - $ 3,057.00 100% - 22 Wiring Device-Material 5 1,832 5 1,837.00 • $ - 5 1,832.00 100% S • 23 Security/Fire Alarm Equipmen:-Labor $ 1,000 $ 1,000.00 - $ • 5 1,000.00 100% 5 24 SecudylFve Alarm Equipment-Material $ 23,700 5 23,700,00 - S - 5 23,700.00 100% 5 • 25 Tele/Da%Cabling-Labor $ 1,800 5 1,800.00 - S - $ 1,800.00 100% $ - 28 TelelData Cabling-Malarial S 1,800 S 1,800.00 • $ - $ 1,800.00 100% 5 - 27 Allowance $ 35,000 5 35,000.00 - $ - $ 35,000.00 100% S - s Original Contract Totals $ 455,900.00 S 455,440 $ - 5 • 5 405,440.00 100% $ 480.00 Change Orders'. CO a01 $ (5,640) 3 - $ - 5 - 5 - 0% 5 (5,840) CO 402 S 69,202 5 69,202.00 5 - S - $ 69,20200 100% F PR#019 5 7,236 $ 8,875.00 $ 361.00 S - $ 7,235.00 100% S PR#072 5 31,437 S 78,295.00 S 2.642.00 $ - 5 30,937.00 98% 5 - 500 Totals for Chancre Orders 5 102,235.00 5 10437200 $ 3,003,00 5 - 5 107,375,00 5 (5,14000) PROJECT TOTALS $ 568,135,00 5 509612.00 $ 3,00300 $ - S 572,81500 101% 5 (4.880 00) Pondrng Change Orders: PROJECT TOTALS $ 568.13500 5 559,812 S 3.00300 $ - S 572.8150D 101% $ (4.030 00) NLLACE-GRED:•GARAGE PARPUNG7C-3-APPS ad CONTRACTORS APPLICATION FOR PAYMENT DETAIL GARAGE/PARKING STRUCTURE Page #2 CONTRACTOR' SIDNEY ELECTRIC CO. City Contract Number 4460913 - OWNERS NAME. SIGNATURE CONSTRUCTION Signature Construction Contract Number 12011 PROJECT NAME. VILLAGE ON THE GREEN.GARAGE/PARKING STRUCTURE PARCEL 7C-3 Aopleacon Number 9 Appllea:lon Date 12/13/2010 Application Period'. A I e C 0 I E O H Work Competed Item Doecnpbcn of Work Scheduled Previous This Stored Total % Balance No. Value Application Period This Period Completed (F/C) To Finish Sidney Electric Company AIA Application And Certificate for Payment Information Original Contract Sum $ 465,900.00 Net Change by Change Orders $ 102,235.00 Contract Sum to Date $ 568,135.00 Total Labor&Material $ 572,815.00 Total Stored Material $ - Total Completed To Date .5 572,815.00 Retainage @ 10% $ 57,281.50 Total Retainage $ 57,281.50 Total Earned Less Retainage $ 515,533.50 Less Previous Certificates for Payment $ 512,830.80 Current Payment Due $ 2,702.70 Balance to Finish Including Retainage $ 52,601.50 VILLAGEGREENGARAGE PARKING re-]'M?a gat WAIVER OF LIEN KNOW ALL MEN BY THESE PRESENTS, that the undersigned being duly authorized by Sidney Electric Co. for and in consideration of$2702.70 to be paid to the undersigned, does hereby waive, release and surrender any and all lien or claim or right of lien to the date of this waiver, for labor, material and/or services furnished upon the premises described as follows. VILLAGE ON THE GREEN GENERAL SITE ENGINEERING 7C-10 John S. Frantz President December 10, 2010 State of Ohio County of Shelby Subscribed and acknowledged in my presence at Sidney, Ohio on the 10 day of December, 2010 Susan R. Maier (f `� _ !r`�, SUSAN R. MAZER 1 01A /� l ��cliu l`:` .? '; ` Notary Public,State of Ohio / ' : n s=My Commission Expires June 4,2011