HomeMy WebLinkAboutSIGNATURE CONSTRUCTION, LLC- 001405- 11/18/2010 . CARMEL REDEVELOPMENT COMMISSION 001405
Signature Construction, LLC Check: 1405
720 3rd Ave., SW Date: 11/18/2010
Carmel, IN 46032 • Vendor: SIGNATO1
Prior
Invoice P.O. Num, Invoice Amt Balance ' Retention Discount Amt. Paid
2-6 3,565.76 3,565.76 0.00 0.00 3,565.76
App 6 for p5 Waterproofing
3,565.76 3,565.76 0.00 0.00 3,565.76
PpZSHUEy.�C, Carmel Redevelopment Commission 00.1.405 •
30 West Main Street A REGIONS
Suite 220 20.1421/740
OCAflMEL` Carmel, IN 46032
. 1405
DATE AMOUNT
11/18/2010 3,565.76
PAY THE SUM OF THREE THOUSAND FIVE HUNDRED SIXTY FIVE DOLLARS AND 76 CENTS
TO THE
ORDER
OF • Signature Construction, LLC
720 3rd Ave., SW `SENs„
" Carmel, IN 46032 i
a
46032 '‘, 4C
11'00 140511' 1:0740 i4 2131: 0087504 l l LP
CARMEL REDEVELOPMENT COMMISSION 001405
Signature Construction, LLC Check: 1405
720 3rd Ave., SW Date: 11/18/2010
Carmel, IN 46032 Vendor: SIGNATO1
Prior
Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid
2.6 3,565.76 3,565.76 0.00 0.00 3,565.76
App 6 for p5 Waterproofing
3,565.76 3,565.76 0.00 0.00 3,565.76
APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT 6702 PAGE ONE OF 2 PAGES 2
TO OWNER Cannel Theater Development Colnl PROJECT: Cannel City PI 11 Waterproofine APPLICATION NO Invoice#6 I Distribution to:
One Civic Square Signature costs _ OWNER
Cannel Indiana 46032 jARCIi1TECT
PERIOD TO: 09/24/2010 L X CONTRACTOR
FROM CONTRACTOR: VIA ARCHITECT: I'edcor Design
Signature Construction Services LLC
720 3rd Avenue S.W. PROJECT NOS:
Carmel_.Indiana 46032
CONTRACT FOR: CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's 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 0703.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
payments received from the Owner,and that current payment shown herein is now due.
I. ORIGINAL CONTRACT SUM 5 80,586.00
2. Net change by Change Orders $ 0.00 CONTRACTOR:
3. COMI'RAC'r SUM TO DATE(Line I • 2) $ 80.586.00
4. TOTAL COMPLETED&STORED TO S 3,565 76
By: ` r Date: 9/7//o
5. RETAINAGE: Thoth? .Koontz,President kJ., 9G/7U
7'7 a. 0 %of Completed Work $ 0 Stibscribed a c sworn to before me this 7 day of D..,.,.d.i.2067
(Column 17+E on G703) LINDA BUCHANAN
h. °,i,of Stored Material $ ?�,;,, ?`+ Hancock County
(Column I'on 0703) sic.: My Commission Expires
Total Retainage(Lines 5a+5h or ''.'*i.' August 20,2011
Total in Column I of 0703) $ 0.00 E - ' •R • .
6. 101 AL EARNED LESS RETAINAGE S 3,565.76 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 front prior Certificate) $ 0.00 the quality of the Work is in accordance with the Contract Documents,and the Contractor
8. CURRENT PAYMENT DUE 5 3,565.76 F is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE.TO FINISH,INCLUDING RETAINAGE $ 77,020 24
(Line 3 less Line 6) AMOUNT CERTIFIED $ 3 546.710,
CHANGE ORDER SUMMARY ADDEIIONS DEDUCTIONS (4naclr explanation ifa au certified differs flow the amount applied.Initial all figures on this
Total changes approved Application and mu •C nianm - 1 Sheet that are changed to con farm with the amount certified.)
in previous months by Owner ARCI Il'l'ECT: .//'�^
Total approved this Month By: V`��--� 6 Date: 7/ //0
TOTALS $0.00 $0.00 This Certificate is not negotiable The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance,payment anti acceptance of payment are wtttiout
NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract.
AIA DOCUMENT G702•APPLICATION AND CERTIFICATION FOR PAYMENT'1992 EDITION-MA '01992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,NW.,WASHINGTON,DC 20006-5292
Users may obtain validation of this document by requesting a completed AIA Document D401 -Certification of Document's Authenticity from the Licensee.
Director of Redevelopment / GS C
tics-
SIGNATURE CONSTRUCTION LLC
720 3rd Avenue, S. W.
_ Carmel, Indiana 46032
1 I I 1 I
Invoice # 6
9/24/10
Carmel City Pill Waterproofing-SMOCK
Carmel, Indiana
1 I 1 1
Total Work RETAINAG£ 1 BALANCE
Scheduled Completed WITHHELD PREVIOUS TOTAL COMPLETED TO
DESCRIPTION Value This period THIS PERIOD APPLICATIONS TO DATE 1 % FINISH
General Conditions: SMOCK FANSLER
Testing and Inspecting 0.00 0.00 0.00 0.00 0% 0.00
Project Management 0.00 0.00 0.00 0.00 0% 0.00
Site Supervision 40,293.00 0.00 0.00 0.00 0.00 0% 40,293.00
Site Safety Director 0.00 0.00 0.00 0.00 #DIV/0! 0.00
Design Drawings 0.00 0.00 0.00 0.00 #DIV/0! 0.00
Temporary Electric 0.00 0.00 0.00 0.00 #DIV/0! 0.00
Office Supplies 0.00 0.00 0.00 0.00 NDIV/0! 0.00
Tools and Equipment 0.00 0.00 0.00 0.00 _ HDIV/0! 0.00
Field Engineering and Surveying 0.00 0.00 0.00 0.00 #DIV/0! 0.00
Construction Management Fee 40,293.00 3,565.76 0.00 0.00 3,565.76 9% 36,727.24
80,586.00 3,565.76 0.00 0.00 3,565.76 4% 77,020.24
CONDITIONAL AFFIDAVIT AND WAIVER OF LIEN
STATE OF INDIANA
COUNTY OF HAMILTON )
Thomas E. Koontz being duly sworn states that he is the President of Signature
Construction, LLC having contract to furnish certain materials and! or labor as
follows: Construction Management Services for a project known as Carmel City
Center P111, located at Carmel, Indiana and owned by the
Carmel Redevelopment Commission and does state:
CONDITIONAL WAIVER:
that the balance due from the owner is the sum of three thousand five hundred
sixty-five dollars and seventy-six cents ($3,565.75) the payment of which has been
promised as the sole consideration for this Affidavit and Conditional Waiver
of Lien which is given to and for said amount, effective upon receipt of such
cash payment. •
THEREFORE, the undersigned waives and releases unto the Owner of said premises any
and all line or claim whatsoever on the above-described property and improvements
thereon on account of labor or material or both, finished by the undersigned thereto, and
further certifies that no other party has any claim or right to a lien on account of any
work perform or material furnished to the undersigned for the said project, and within the
scope of this affidavit and waiver.
SIGNATURE CONSTRUCTION, LLC
Thome E. Koo , President
Subscribed and sworn to before me this: 117774
Notary Public:
•
LINDA BUCHANAN
Hancock County
My Commission Expires
't' 'aa'.'?itC: August 20,2001