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Home My WebLink AboutRL TURNER- 150- 1/5/2011 RL Turner Check: 150 Date: 1/5/2011 Vendor: RL TURNE Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount. Amt. Paid 4-9 4,900.00 4,900.00 0.00 0.00 4,900.00 App 9 on PC-6 Site Utility wor 4,900.00 4,900.00 0.00 0.00 4,900.00 150 1/512011 '*****'"*4,900.00 THE SUM OF FOUR THOUSAND NINE HUNDRED DOLLARS AND NO CENTS "'"''""`********',,. RL Turner RL Turner Check: 150 Date: 1/5/2011 Vendor: RL TURNE Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 4-9 4,900.00 4,900.00 0.00 0.00 4,900.00 App 9 on PC-6 Site Utility wor 4,900.00 4,900.00 0.00 0.00 4,900.00 pm .....,,,,... .. A_......AI ...... Document G7 02TM - 1992 _:::::::::;:il Application and Certificate for Payment TO OWNER: .: PROJECT: APPLICATION NO•'''+ Distribution to: ' 'SIGNATURE CONSTRUCTION VILLAGE ON THE GREEN C-6 9 CUST7 09 26F 720 THIRD AVE SW PERIOD TO I f/22,20I0 OWNER U CONTRACT FOR 12016 ARCHITECT ❑ CARMEL M 46032 FROM CONTRACTOR: VIA ARCHITECT: -. CONTRACT DATE: 10101!009 CONTRACTOR C RI_TURNER CORPORATION 1000 West Oak Street PROJECT NOS: i / FIELD 0 Zionsville,IN 46077 • o a FIT 1l nr aft OTHER ❑ CONTRACTOR'S AI � Ca N FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information Application is made for payment,as shown below,in connection with the Contract and belief the Work covered by this Application for Payment has been completed in accordance Continuation Sheet,AIA Document 6703.is attached. 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 from the Owner, and 1.ORIGINAL CONTRACT SUM $ 73,000.00 that current paymet raven herein is now due. • •2. Net change by Change Orders $ 000 CON •R: EL er Corporation, David "Petty , Proj ect Mgr 3.CONTRACT SUM TO DATE(Line lr+ 2) $ 73 000 00 RY t� Date: KIEV 0 4.TOTAL COMPLETED&STORED TO DATE(Column G on 0701) $ 75,040.100 State oL Indiana 1, �A{�JORIE A,"CFTC 5.RETAINAGE County of: ma-ion NOTAR'Y PllRLIC a %n of Completed Work - Subscribed and sworn to'before SEAL 5'l4Lolnnin D+Eon 0703) $ 9 96300 me this 22nd day of November, 2010 STATE Ex Ir $Yres Feb.Feh 13.2Ut7 b Wed"Stored Material Goma'issio[5 E%F ' mnoonG703 I C7-u¢ r Marjorie A. Leto (` ) $ ono Notary PobLc R�1� My Commission cxp 2/19/2017 Total Retainage(Lines Sa+Sb or Total in Column I of G703).... . $ 196s en 6.TOTAL EARNED LESS RETAINAGE S 69 tits 00 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 Less Line 3 Total) . In accordance with the Contract Documents,based on en-site observations and the data comprising 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT 5 641 "00 this application,the Architect certifies to the Owner that to the best of the Architect's knowledge, (tine 6 from prior Certificate) information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the 8.CURRENT PAYMENT DUE $ 4,900.09 AMOUNT CERTIFIED. 4/7 /� 9.BALANCE TO FINISH, INCLUDING RETAINAGE AMOUNT CERTIFIED $ 7 ( OD (Line.3 less Lino 6) $_i._bY no (Arrrtck esplanw.ion if amount certified differsfr-orio the UProlult applied. Initial all figures on this Application rind im the Conthuoiricin Sheer that are changed to conform taoith the(21■uunT certified.) CHANGE ORDER SUMMARY ADDITIONS DEDUCT IONS -ARCIVTET Tr:: '�7�t"'l"'-'� t fI Total changes approved in previous months by Owner $ 0 00 $ 0.00 _ By: /2- "_ ---,Date: t2 Hbo Ton!approved this-Month $ 0.00 $ 0,00 This Certificate is not negotiable.The AMOUNT CER'p1FIED is payable only to the Contractor TOTALS $ _000 $ 0 00_, named herein.Issuance payment and neceptance of payment arc without prejudice to any rights of NET CHANGES by Change Order $ 0,00 the Owner or Contractor under this Contract 17//2 -- 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. Al A Document G702TM—1992.Copyright Q 1953 5963.1965,1971 1978. 1983 and 1992 by The American Institute of Architects.All rights reserved,WARNING:This AtA® 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 he prosecuted to the maximum extent possible under the law.Purchasers am permined to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. g = Document 6703 - 1992 Continuation Sheet Pace 1 of ALA Document(37027M, Application and Certification for Payment, APPLICATION NO: 9 containing Contractor's signed;certiffcation is attached_ APPLICATION DATE: 11/22/2010 In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contract,:where variable retainage 1-'or line items may apply PERIOD TO: 11/22/2010 . ARCHITECT'S PROJECT ICJ 16 A B C 1) E E G H i WORK COMPLETED TOTAL MATERIALS BALANCE ITEM DF,SCRIP'I'ION[7F WORK SCHEDULED FROM PREVIOUS PRESty\TLS' COMPLETED TO RETAN'AGE AND STORED NU. VALUE„ APPLICA'T'ION THIS PERIOD STORED (G=C) FINISH OfI:unable r ate) (D +F,) (Nurin D or E) 7"U DATE, (L• CO (fJ+Ei FIr 0100 !elfo mane R 1,460.00 1,460.00 1,460.00 1L0.00 ayment Bond 0110 T Supervision 4,900.00 4,900.00 4,900.00 110.00 0120 rater Labor 2,500.00 2,500.00 2.500.00 110:00 0130 I'later Material 2,500.00 2,500.00 2,500.00 110.00 0140 torm Labor 14,640.00 14,640.00 14,640.00 1 0.00 0150 tonn Material 11,700.00 11,700.00 11300.00 110.00 0160 Anita Y Labor 14.900.00 14,900.00 14,900.00 U 0.00 • 0170 anitary Material 15.500 00 15,500.00 15,500.00 110.00 0180 spiral(Paving,Labor 1,000.00 1,000.00 1,000.00 1 0.00 0190 sphall Paving 3,900.00 3.900.00 3,900.00 1 0.00 Material • • JOB TOT lvDTOT I. 73,000.00 68,100.00 4,900,00 ,.00 73,000.00 ! .00 3,965.00 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 G703TM'-1992.Copyright®1963, 1965, 1966,1967, 1970,1978,1983 end 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 Ale 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 ton(it 9)copies of this document when completed.To report copyright violations of AIA Contract Documents,a-mail The American Institute of Architects legal counsel,copyrightr@aia.org. • AFFIDAVIT AND WAIVER OF LIEN Final X Partial Payment to Follow State of Indiana, County of Marion, SS: MENDEL G. SMITH, being duly sworn, states that he is the VP OF OPERATIONS of R. L. TURNER CORPORATION having contracted with SIGNATURE CONSTRUCTION to furnish certain materials and/or labor as follows: Per Contract for a project known as VILLAGE ON THE GREEN PARCEL 7C-6 CONTRACT 6 located in CARMEL, IN and owned by THE CITY OF CARMEL REDEVELOPMENT COMMISSION and does hereby further state: (PARTIAL WAIVER) that the balance due from the owner is the sum of: Four thousand nine hundred and 00/100 dollars ($4,900.00} receipt of which is hereby acknowledged; or the payment of which has been promised as the sole consideration x for this Affidavit and Partial Waiver of Lien is given to and for said amount, effective upon receipt of such payment. (FINAL WAIVER) that the balance due from the owner is the sum of: receipt of which is hereby acknowledged; or the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien is given to and for said amount, effective upon receipt 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 or material or 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. R. L. TURNER CORPORATION,INC. MARJORIE A. LETO� 1 . 1 NOTARY PUBLIC E By _ J✓\ ♦ A SEAL MENDE, G. SMITH, VP OF OPE• TIONS STATE OF INDIANA My Commission Expires Feb. 19.2017 WITNESS MY HAND AND NOTARIAL SEAL, this 22nd day of November, 2010. Marjorie A. Lo Nary Public County of residence: Marion My commission expires: 02/19/2017 •