HomeMy WebLinkAboutSMOCK FANSLER CORPORATION- 001364- 11/18/2010 Smock Pander Corporation Check: 1364
2910 W Minnesota Street Date: 11/18/2010
Indianapolis, IN 46241-4541 Vendor: SMOCKFA1
Prior
Invoice ' P.O. Num. Invoice Amt Balance Retention Discount Amt. Pal
2950 49,678.92 49,678.92 0.00 0.00 49,678.9
P111 Pavers -
49,678.92 49,678.92 0.00 0.00 49,678.9
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.-, *,.,a-a=A THISICHEC .
i -` P,. 7i'11; Carmel Redevelopment Commission 0 013'6 4
A er
S West Main Street A REGIONS.
L Suite 220 20-1421 n40
oc""ME S Carmel, IN 46032
STRIc
1364
DATE • AMOUNT
11/18t2010 «. ++49,678.92
,f
PAY THE SUM OF FORTY NINE THOUSAND SIX HUNDRED SEVENTY•EIGHT DOLLARS AND 92 CENTS
i TO THE .. - `
ORDER - •
r °F Smock Fansler Corporation
*, 2910 W Minnesota Street :""c'%
• Indianapolis, IN 46241-4541 • _ -
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n'0013Din' 1:07401ti 2 L31: 008 7 504 I. 11u'
CARMEL REDEVELOPMENT COMMISSION 001364
Smock Fansler Corporation Check: 1364
2910 W Minnesota Street Date: 11/18/2010
Indianapolis, IN 46241-4541 Vendor: SMOCKFA1
Prior
Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Pa
2950 49,678.92 49,678.92 0.00 0.00 49,678.5
P111 Pavers
• 49,678.92 49,678.92 0.00 0.00 49,678..
i.
1i?
x II's2LID C(ITFn1erE.se Forms oralson (077)577.57E1 INECE700
REQUEST FOR PAYMENT
From' Smock Fansler Corporation To CARMEL•REDEVELOPMENT COMMISSION Invoice' 2950
2910 W Minnesota Street 30 W.MAIN ST. Draw: APP00002
Indianapolis, IN 46241-4541 CARMEL, IN 46032 Invoice date' 9(17(2010
Period ending date. 9(30(2010
Contract For:
Request for payment:
Original contract amount $805,860.00
Approved changes $0.00 Project: 10081
Revised contract amount $805,860.00 P. 111 PAVERS
Contract completed to date $71,316.00 Contract date:
Add-ons to date $0.00
Taxes to date $0.00
Architect
Less retainage $7,131.60
Total completed less retainage $64.184.40 Scope:
Less previous requests $$14,505,48
Current request for payment $49,678.92
Current billing 555,196.80
Current additional charges $0.00
Current tax $0.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS
Less current retainage $5,519.88 Changes approved in previous
Current amount due $49,678.92 months by Owner
Total approved this Month
Remaining contract to bill $741,675 60 TOTALS
NET CHANGES by Change Order
I hereby certify that the work performed and the materials supplied to date,as shown on the above represent the actual value of the accomplishment under the terms of the
Contract
that the all
contractor has paid changes thereof)amounts between the
billed undersigned ned and the
oCCVARMEL REDEVELOPMENT COMMISSION relating to the above referenced project. I also �� „SlA lf?Y��PVB,..?„
CONTRACTOR: Smock Fansler Corporation State Of INDIANA County Of MORGAN
y2 �7 A
By: R\Y 7 Vi �/Ll Subscribed and sworn to before me this lit t day of �yn (0 - SEA '
/�/ 7 47, <1.Ct �
Date: %f /lv _ Notary Public 9 r
L My commission expir { /��� (/��Oj%4T�1• •..•. 4Lai\\.
t 1 6 LLL i nizlllaim)1M111P��w
�`5► ��2'] YO CorVSTRvcrwJ Mhulc � c� �
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CCa) sa*t rr acrs : riffo D 4t) 497d22)7_
Director of Redevelopment r 4Lkzeo —
REQUEST FOR PAYMENT DETAIL
Project: 10081/P.111 PAVERS Invoice: 2950 Draw:APP00002 Period Ending Date: 9/30/2010 Detail Page 2 of 2 Pages
Item ID Description Total Previously Work Presently Completed h Balance Retainage
Contract Completed Completed Stored And Stored Comp To Balance
Amount Work This Materials To Date Finish
Period
01 MOBILIZATION 10,000.00 200.00 300.00 500.00 5.00 9,500.00 50.00
02 FIELD ENGINEERING 10,000.00 200.00 300.00 500.00 5.00 9,500.00 50.00
03 ASPHALT BASE 165,400.00 3,308.00 4,962.00 8,270.00 5.00 157,130.00 827.00
04 UNIT PAVERS 620,460.00 12,409.20 49,636.80 62,046.00 10.00 558,414.00 6,204.60
Totals 805.860.00 16,117.20 55,198.80 71,316.00 8.85 734,544.00 7.131.60
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AFFIDAVIT AND WAIVER OF LIEN
[ ] Final [X] Partial [X] Payment to Follow
State of Indiana
County of Marion
T.M. Fansler being duly sworn states that he is the CEO of SMOCK FANSLER CORP.
having contracted with: Carmel Redevelopment Commission to furnish certain labor, materials,
and/or services as follows: Misc. Construction for a project known as: SFC#10-981 P. 111 Pavers
located at Carmel, IN and does hereby state on behalf of the aforementioned contractor:
(PARTIAL WAIVER)that there is due from the owner the sum of: ($49,678.92)
•
Forty Nine Thousand Six Hundred Seventy Fight Dollars and 92/109
[ ] receipt of which is hereby acknowledged; or
[X] the payment of which has been promised as the soleconsideration of this Affidavit and Partial Waiver of
Lien which is given solely with respect to said amount, and which waiver shall be effective only upon
receipt of payment thereof by the undersigned;
(FINAL WAIVER) that the final balance due from the owner is the sum of($9.00)
[ ] receipt of which is hereby acknowledged; or
[ ] the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of
Lien which shall become effective upon receiptof 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,
Materials, and/or Services, furnished by the undersigned thereto, subject to limitations or conditions
expressed herein, if any; and further certifies that no other party has any claim or right to a lien on
account of any work performed, materials, or services furnished to the undersigned for said project, and
within the scope of this affidavit and waiver. ���/
SMOCK FANSLER CORP. By � ,C\� '� ` .itle CEO
M. ansler
WITNESS MY HAND AND NOTARIAL SEAL, this 17th day of September ,2910. ytiwuuitti w
oO O/ ,/ PRY PU@ "%,
Melissa J. Bishop Notar y Public
SEAL 3
My commission expires November 30, 2016 Residing in Morgan County