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DIVERSIFIED PAINTING COMPANY- 001345- 11/18/2010
A CARMEL REDEVELOPMENT COMMISSION 001345 Diversified Painting Company Check: 1345 1661 Expo Lane Date: 11/18/2010 Indianapolis, IN 46214 Vendor: DIVERSI1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 11 53 196,800.00 196,800.00 0.00 0.00 196,800.00 Application 11 196,800.00 196,800.00 0.00 0.00 196,800.00 ARROMMUMMTHISICHECIWASVAICOLCIREDISACKGROLIND7ANDZONTAINSMIULTIPLIE;SECURITNAEATURESPSEEfBACKWORTDETAILISIN .9:15 FS�o� Carmel Re 1 development Commission 00,13'45 30 West Main Street at Suite REGIONS 220 20-1421n40 CAREL °�sMrR1, Carmel, IN 46032 1345 DATE AMOUNT 11/18/2010 **********196,800.00 PAY THE SUM OF ONE HUNDRED NINETY SIX THOUSAND EIGHT HUNDRED DOLLARS TO THE ORDER OF Diversified Painting Company 1661 Expo Lane SENso zP Indianapolis, IN 46214 ,_ p M G9RFA TOE"- 00013450 1:0740L42L31: 0087504L1L0 CARMEL REDEVELOPMENT COMMISSION 001345 Diversified Painting Company Check: 1345 1661 Expo Lane Date: 11/18/2010 Indianapolis, IN 46214 Vendor: DIVERSI1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 11 53 196,800.00 196,800.00 0.00 0.00 196,800.00 Application 11 _ 196,800.00 196,800.00 0.00 0.00 196,800.00 r ocu ent 72/ : Tm ® 1992 , 53 . Application; lication and Certificate f pp or Payment Construction��Manager Adviser Edition ' _ TO OWNER: PROJECT: i APPLICATION'NO Carmel Redevelopment Commission PARCEL 7A Regional Performing Arts Center to tribut` n t Dis o One Civic Square Intenor Finish Package P5 PERIOD TO: 9/15/10 OWNER ❑ Carmel,IN 46032 Bid Pack;#5160;Painting CONSTRUCTION MANAGER ❑ Febuary24,2009 FROM COIi�4i30APatnting Company VIA CONSTRUCTION MANAGER: CONTRACT DATE; 2695 ARCHITECT ❑ 1681 Expo Lane CSO Architects Indianapolis,IN 46214 280 E.-96th-Street Street,Suite 100 PROJECT.NOS. / / CONTRACTOR ❑ VIA ARCHITECT:` Indianapolis IN 46240 'FIELD ❑ - Bid Pack 5160;Painting CONTRACT FOR: ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and Application is made for payment,as shown below,in connection with the Contract belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet,MA Document G703,is attached. 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 1.-ORIGINAL CONTRACT SUM $ o i oo n00'nn payment shown herein is n` d 2. Net change by Change Orders $ (55,55n on) CONTRACTOR: .e 1 . 3.CONTRACT-SUM TO DATE(Line 1 ±2) $ 2,044,450.00 By: Date: 9/15/2010 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,620,653.96 State of: INDIA A 5:RETAINAGE: Boo Thomas E. Hill County of: ' J a. %q of Completed Work e( Art +. A: Notary Public State of Indiana! o Subscribed and sworn to befo .,81� Boone County (CO1i fliD+Eon G703) :• ,072.00 me this day of 9/15 ' Expires Nov 8,2017 b. 10%of Stored Material N Hill otary Public: Thom (Column F on G703) 1 ,150.00 My Commission expires: 11/08/2017 Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ CERTIFICATE FOR PAYMENT 102,222:00 6.TOTAL EARNED LESS RETAINAGE In accordance with the Contract Documents, based on on-site observations and the data comprising $ 1,518,431.96 this application, the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1,32 1,631-.96 accordance with the Contract Documents,and the Contractor is entitled t payment quality of the Work is Nn (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated, tied to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE $ 196;800.00 AMOUNT CERTIFIED t_ e, 9 BALANCE-TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs r i the amount applied Initial all figures on this Application an C nt changed to conform with the amount certified.) (Line 3 less Line"6) 516,018.04 . CONS \ CTI ad o , GAO.o iric On Continuation-Sheet t at ar _ ,ay//: �446 . ,4,..• Date: 0 /D ` By: CHANGE ORDER SUMMARY ADDITIONS '" DEDUCTIONS r ARCHITECTS : - Total changes approved in previous months by Owner $; $ By 1 Date: approved this. Wit Zit ( Total a $' $ E. ,_ This C -negotiable. The AMOUNT CERTIFIED is_payable only to the Contractor TOTALS $, $ named he eln. Issuance,_payment and acceptance of payment are without prejudice"to any rights.of. NET;CHANGES by Chancre-Order $ J the Owner or Contractor under this Contract. CAUTION You should si n an original AIA Contract.Docu ent on:which ths text appears in RED An onginal assures that changes will not be obscured.` ,- AIA Docum enYG702/CMa-_ _1992:Copyright©1992 b The American Institute of.Ar hitec ts.?:All'ii ghts.reserved.WARNING:This ® " AIA Document is protected by U:S::Copyright .aw and International Treaties." xip" »Unauthorized reproduction or distribution of this A1A..Document,or ' - any portion,of it;_may in civil and criminal penalties;.arid will.be;prosecuted to the maximum extent possible under the law. Purchasers:are ermitted_to=rero. ra m�, p.,. p duce ten(10)copies ofahis document when.completgd.To repop;co n ht:violahonsof AIA=Gontract<D uments==- ; <, , . ,,,.,., _ ,. ,:: „p1-, g, ,,,, _,_,,,,oc ,e mail,The American Institute of Architects legal counsel,copyngFii @aiaiorg, , ,,, iAIA ocu ent 7®3TM ® 1992 page 1 Continuation Sheet AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: containing Contractor's signed certification is attached. 11 In tabulations below,amounts are stated to the nearest dollar. APPLICATION DATE: 40436 Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 9/15/2010 ARCHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED MATERIALS TOTAL SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED BALANCE RETAINAGE ITEM DESCRIPTION OF WORK STORED AND STORED /o TO (0_C) NO. VALUE APPLICATION THIS PERIOD (IF VARIABLE (NOT IN TO DATE FINISH C- RATE) ) (D+E) D OR E) (D+E+F) (C 1 Bonds 73,500.00 73,500.00 73,500.00 100% 0.00 7,350.00 2 Moblilization 5,000.00 5,000.00 0.00 5,000.00 100% 0.00 500.00 3 Insurance/Hazcom/Safety 4,000.00 4,000.00 4,000.00 100% 0.00 400.00 4 Submittals 4,800.00 4,800.00 4,800.00 100% 0.00 480.00 5 09-72-00;WALLCOVERING Labor 18,750.00 2,500.00 8,500.00 11,000.00 59% 7,750.00 1,100.00 Material 37,000.00 26,000.00 7,500.00 33,500.00 91% 3,500.00 3,350.00 6 09-84-00;ACOUSTICAL WALL PANELS Labor 51,500.00 12,500.00 9,000.00 21,500.00 42% 30,000.00 2,150.00 Material 480,000.00 59,800.00 75,000.00 181,500.00 316,300.00 66% 163,700.00 31,630.00 7 09-91-00;PAINTING BASE MECH Labor 36,680.00 36,680.00 0.00 36,680.00 100% 0.00 3,668.00 BASE MECH Material 9,000.00 9,000.00 0.00 9,000.00 100% 0.00 BASE ELECT LABOR 10,080.00 10,080.00 0.00 ° 900.00 10,080.00 100% 0.00 1,008.00 BASE ELECT MATER 2,500.00 2,500.00 0.00 2,500.00 100% 0.00 250.00 INT CONST BASE LAB 10,880.00 10,300.00 0.00 10,300.00 95% 580.00 1,030.00 INT CONST BASE MAT 2,500.00 2,375.00 0.00 2,375.00 95% 125.00 237.50 PLEM LABOR 8,480.00 8,050.00 0.00 8,050.00 95% 430.00 805.00 PLEM MATERAIL 2,500:00 2,400.00 0.00 2,400.00 96% 100.00 240.00 CON HALL N WALL LABOR 69,120.00 64,000.00 0.00 64,000.00 93% 5,120.00 6,400.00 CON HALL N WALL MATERIAL 27,500.00 26,000:00 0:00 0.00 26;000.00 95% 1,500.00 2,600.00 CON HALL N DOME LABOR 45,920.00 45,920.00 0:00 45,920.00- 100% 0.00 3,000.00 CON HALL N DOME MATERIAL 30,000:00 30,000.00 0:00 0.00 30,000.00 100% 0.00 3,000.00 CON HALL BALY WALL LAB 122,240:00 117;500.00 0:00 117;500:00 96% 4,740.00 11,750.00 CON HALL BALY WALL MAT 44,000:00 41,700.00 0:00 0.00 411,700.00 95% 2,300.00 4,170.00 • :e,:::.:i : 00 , ,00- 876,105.00 2u.I5 • � 219,845.00 81,61(150 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 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®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 .r possible under the law.Purchasers are permitted 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,copyrighta@aia;org. . 411P -,......---A A Document G703TM ® 1992 Continuation Sheet page 2 AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: containing Contractor's signed certification is attached. APPLICATION DATE: In tabulations below.amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD T0: 11 ARCHITECT'S PROJECT NO: 9/15206 0 A B C - D E F G H _ I WORK COMPLETED MATERIALS TOTAL PRESENTLY COMPLETED BALANCE ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS % TO IF VARIABLE A AGE NO. STORED AND STORED (G.'C) FINISH (IF VALUE APPLICATION THIS PERIOD (D+E) (NOT IN TO DATE RATE) D OR E) (D+E+F) (C-G) CON HALL DOME LABOR 100,260.00 100,260.00 0.00 100,260.00 100% 0.00 10,026.00 CON HALL DOME MATERAIL 55,000.00 55,000.00 0.00 0.00 55,000.00 100% 0.00 5,500.00 CON HALL S WALL LABOR 45,120.00 34,250.00 0.00 34,250.00 76% 10,870.00 3,425.00 CON HALL S WALL MATERIAL 29,500.00 27,500.00 0.00 0.00 27,500.00 93% 2,000.00 2,750.00 CON HALL S DOME LABOR 45,920.00 45,920.00 0.00 45,920.00 100% 0.00 4,592.00 CON HALL S DOME MATERIAL 25,000.00 25,000.00 0.00 0.00 25,000.00 100% 0.00 2,500.00 N TIER LABOR 28,000.00 21,000.00 0.00 21,000.00 75% 7,000.00 2,100.00 N TIER MATERIAL 6,500.00 5,000.00 0.00 5,000.00 77% 1,500.00 500.00 N ORCH LABOR 28,000.00 22,000.00 0.00 22,000.00 79% 6,000.00 2,200.00 N ORCH MATERIAL 6,500.00 5,500.00 0.00 5,500.00 85% 1,000.00 550.00 W LOBB LABOR 28,800.00 16,750.00 5,000.00 21,750.00 76% 7,050.00 2,175.00 W LOBB MATERAIL 6,500.00 4,000.00 0.00 4,000.00 62% 2,500.00 400.00 W LOBB CEIL LABOR 28,000.00 25,250.00 0.00 25,250.00 90% 2,750.00 2,525.00 W LOBB CEIL MTERAIL 6,500.00 6,500.00 0.00 6,500.00 100% 0.00 650.00 E LOBBY LABOR 28,000.00 14,000.00 14,000.00 50% 14,000.00 1,400.00 E LOBBY MATERIAL 7,000.00 3,000.00 3,000.00 43% 4,000.00 300.00 E LOBBY CEIL LABOR 38,800.00 19,000:00 7,600.00 26,600.00 69% 12,200.00 2,660.00 E LOBBY MATERIAL 9,300.00 4,650.00 2,000.00 6,650.00 72% 2,650.00 665.00 S LOBB LABOR 45,000.00 22,500.00 12,500.00 35,000.00 78% 10,000.00 3,500.00 S LOBB MATERIAL 11,000.00 7,000.00 1,500.00 8,500.00 77% . 2,500.00 850.00 SW ORCH LOB,STR WAL LAB 48,000.00 18,000:00 18,000.00 36,000.00. 75% 12,000.00 3,600.00 SW ORCH LOB,STR WAL MAT 8,700500 4,000.00 3,700:00 7,700.00 89% 1,000.00 770.00 SE ORCH LOB,STR WAL LAB 48,000.00 39,000.00 0:00 39,000:00 81% 9,000.00 3,900.00 SE ORCH LOB,STR WAL MAT 8,700.00 6,700:00 0.00 6,700.00 77% 2,000.00 670.00 • '' 692,100.00 5-14,78(100 67,300.00 6760 i:i,ii .,. ,,., 58,YUt1.00 - _ 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 and 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 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. 1ng/// =. , Document 6703 TM - 1992 Co ntinuation Sheet page 3 AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION!NO containing Contractor's signed certification is attached. APPLICATION DATE: 11 In tabulations below,amounts are stated to the nearest dollar. 40436 Use Column I on,Contracts where variable retainage for line items may apply. PERIOD TO: 9/15/2010 ARCHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED I MATERIALS TOTAL PRESENTLY COMPLETED BALANCE RETAINAGE SCHEDULED FROM PREVIOUS % TO ITEM DESCRIPTION OF WORK STORED AND STORED (IF VARIABLE NO VALUE APPLICATION THIS PERIOD (G_C) FINISH (NOT IN TO DATE RATE) (D+E) D OR E) (D+E+F) (C-G) BAL L/H LABOR 28,000.00 21,000.00 0.00 21,000.00 75% 7,000.00 2,100.00 BAL L/H MATERAIL 6,800.00 5,800.00 0.00 5,800.00 85% 1,000.00 580.00 INT CON ATTIC LABOR 17,000.00 17,000.00 0.00 17,000.00 100% 0.00 1,700.00 INT CON ATTIC MATERIAL 3,500.00 3,500.00 0.00 3,500.00 100% 0.00 350.00 3 09-97-23; STAINS, SEALERS BASEMENT Labor 7,700.00 5,500.00 0.00 5,500.00 71% 2,200.00 550.00 BASEMENT Material 5,800.00 5,500.00 0.00 5,500.00 95% 300.00 550.00 BASE MECH RM LABOR 2,500.00 1,250.00 0.00 1,250.00 50% 1,250.00 125.00 BASE MECH RM MATER 1,500.00 750.00 0.00 750.00 50% 750.00 75.00 PLEM LABOR 2,500.00 1,250.00 0.00 1,250.00 50% 1,250.00 125.00 PLEM MATERAIL 1,500.00 750.00 0.00 750.00 50% 750.00 75.00 CON HALL BALCONY LAB 4,500.00 0.00 0% 4,500.00 0.00 CON HALL BALCONY MAT 1,500.00 0.00 0% 1,500.00 0.00 ORCH LOB, STR LAB 7,500.00 0.00 0% 7,500.00 0.00 ORCH LOB, STR MAT 3,000.00 0.00 0% 3,000.00 0.00 9 DAILY CLEAN UP 15,000.00 8,000.00 3,000.00 11,000.00 73% 4,000.00 1,100.00 10 GENERAL ALLOWANCE 100,000.00 89,118.96 7,500.00 96,618.96 97% 3,381.04 9,661.90 11 SUPPLIES ALLOWANCE 15,000.00 2,200.00 4,000.00 6,200.00 41% 8,800.00 620.00 12 LABOR ALLOWANCE 75,000.00 18,500.00 15,000.00 33,500.00 45% 41,500 00 3,350.00 13 CAD ALLOWANCE 5,000.00 5,000.00 0.00 5,000.00 100% 0.00 500.00 14 PROGRESS MEETINGS 5,200.00 3,400.00 0.00 3,400.00 65% 1,800.00 340.00 15 CLOSE-OUTS 3,450.00 0.00 0% 3,450.00 0.00 CO 1 DED ALLOWANCE -55,000.00 -55,000:00 0.00 -55,000.00 100% 0.00 -5,500.00 CO 2 0.00 0.00 0% 0.00 0.00 CO 3 -550:00 -55000. 0:00 -550:00 100% 0.00 -55.00 SIBTOTAL PAGE" 256,400.00 132,968.96 29,500.00 0.00 162,468.96 11.48 93,931.04 16,246.90 SUB TOTAL PAGE 1 1,095,950.00 594,605:00 100,000.00 181,500.00 876;105.00 20.15 219,845.00 87,610.50 SUB TOTAL PAGE 2 892,100 nn 14,780 00 67,300.00 0-09 582,080 00 19.21 110,020.00 58,208 00 GRAND TOTAL 2;044 450:00 1 242 353.96 196 80. is 00 I s . 8 . • I : - 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 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®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 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. D. P. Co. Inc. AFFIDAVIT AND WAIVER OF LIEN Payment# 8 & 9 check 1196 STATE: INDIANA FINAL XX PARTIAL - PAYMENT TO FOLLOW COUNTY OF: MARION _kevin M. Blume_Being duly sworn that he is the Secretary of Diversified Painting Co. Inc_being in contract with Carmel Redevelopment Commission to furnish certain materials and/or labor as follows: Painting &Wallcovering for a project known as: Parcel 7A;Regional Performing Arts Center located in: Carmel, IN and owned by_City of Carmel Redevelopment Commission and does hereby further state on behalf of the aforementioned subcontractor/supplier: (PARTIAL WAIVER) That there is due from the contractor the sum of: three hundred eighty thousand three hundred eighty-five and 46/100 DOLLARS: $380,385.46 XXXX receipt of which is hereby acknowledged or the payment of which has been promised as the sole consideration of the 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 there is due from the contractor the sum of: DOLLARS: $ - receipt of which is hereby acknowledged or the payment of which has been promised as the sole consideration of the affidavit and Final Waiver of Lien which is shall become effective upon receipt of such payment. THEREFO 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, subject to limitations or conditions expressed herein, in any, and further certified that no other party has any claim or right to lien on account of any work performed or material furnished to undersigned for said project and within the scope of this affidavit -►• .vier. • Diversified Painting Co. Inc._ : ./ / _ 9 Y" President , in M. Blume WITNESS MY HAND AND NOTA-IAL SEAL THIS: 09/15/10 MY COMMISSION EXPIRES: 11-08-2017 COUNTY OF RESIDENCE: Boone vJ,Q1 NOTARY Thomas E. Hill ak_- i Thomas E. Hill • :'+0TA.,- Notary Public State of Indiana 'Utoc,.-` Boone County Expires Nov 8,2017 p• D. P. CO., INC. DIVERSIFIED PAINTING CO.. INC. 1): 1681 Expo Lane, Indianapolis, IN 46214 (317) 209-9899 fax (317)209-9886 1), w YA° 1b eptember •s, 0 10 0 City of Carmel Redevelopment Commission Re: Trade Secret Notice -REGIONAL PERFORMING ARTS CENTER ("Project") Dear_City of Carmel Redevelopment Commission : Enclosed is the certified payroll you have requested for the above-referenced project. Diversified Painting Co., Inc. is supplying this information for the exclusive review of C- SO ARCHITECTS and the City of Cap Biel Redevelopment Commission_. This . information is not to be shared, copied or passed along to any other parties without the written permission of Diversified Painting Co., Inc. This information is viewed as confidential employee information and contains trade secrets. Anyone forwarding or transmitting this information without written permission by Diversified Painting Co.,Inc.will be held responsible • to the fullest extent permitted by Indiana and federal law. Furthermore, pursuant to the Indiana Public Access Counselor,this information is not disclosable under the Indiana Open Records Act. If you have any questions on this matter, please contact me. Very truly yours, evin Blume President U.S. Department of Labor PAYROLL ..> ' Employment Standards Administration For Contractor's Optional Use; See Instructions at www.dol. ov/esa/whd/forms/wh347instr.htm i_ \c„„,„„!.1,4.,„-d,r: x vx Wage and Hour Division (For g � � Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. Rev. Dec. 2008 NAME OF CONTRACTOR 0 OR SUBCONTRACTOR 0 ADDRESS OMB No.: 1215-0149 D.P. CO., INC. 1681 EXPO LANE, SUITE A, INDIANAPOLIS, IN 46214 Expires: 12/31/2011 PAYROLL NO. FOR WEEK ENDING PROJECT AND LOCATION PROJECT OR CONTRACT NO 000038 8/22/2010 CARMEL PERFORMING ARTS (1) (2) (3) (4)DAY AND DATE (5) (6) (7) (8) (9) y S M. T W T F S DEDUCTIONS NET NAME AND INDIVIDUAL IDENTIFYING NUMBER n o re GROSS WITH- WAGES (e.g.,LAST FOUR DIGITS OF SOCIAL SECURITY,,s- ° WORK F 22 16 17 18 19 20 21 TOTAL RATE AMOUNT HOLDING TOTAL PAID NUMBER)OF WORKER 2. CLASSIFICATION ° HOURS WORKED EACH DAY HOURS OF PAY EARNED FICA TAX CAFETERIA NR LOANS OTHER DEDUCTIONS FOR WEEK 0000000066 0 609.60 06 UNSKILLED S 8.00 8.00 8.00 B.00 32.00 19.05 1029.17 78.73 41.20 51.97 171.90 857.27 0000000064 D 529.20 04 UNSKILLED 3 S 8.00 8.00 8.00 24.00 22.05 1266.44 96.88 97.85 63.96 258.69 1007.75 0000000057 D 784.32 05 SEMI SKILLED S 8.00 8.00 8.00 8.00 32.00 24.51 784.32 60.00 43.35 39.61 142.96 641.36 0000000023 O 980.40 02 SEMI SKILLED 5 B.00 8.00 8.00 8.00 8.00 40.00 24.51 980.40 75.00 76.00 49.51 200.51 779.89 0000000047 0 020.40 05 SEMI SKILL 1 $ 8.00 8.00 8.00 8.00 8.00 40.00 25.51 1020.40 78.06 50.42 51.53 180.01 840.39 0000000007 O 816.32 05 SEMI SKILL 1 $ 8.00 8.00 8.00 8.00 32.00 25.51 1378.23 105.43 104.09 69.60 279.12 1099.11 0000000038 - O 060.40 05 SEMI SKILL 2 $ 8.00 8.00 8.00 8.00 8.00 40.00 26.51 1060.40 81.12 56.42 48.69 186.23 874.17 0000000056 O 848.32 05 SEMI SKILL 2 S 8.00 8.00 8.00 8.00 32.00 26.51 848.32 64.90 24.60 42.84 132.34 715.98 While completion of form WH-347 is optional,it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R.'33,55(a) The Copeland Act (40 U.S.C.°3145)contractors and subcontractors performing work on Federally financed or assisted construction contracts to"furnish weekly a statement with respect to the wages paid each employee during the preceding week."U.S.Department of Labor(DOL)regulations at 29 C.F.R.°5.5(a)(3)(u)require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project,accompanied by a signed"Statement of Compliance"indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis-Bacon prevailing wage rate for the work performed.DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages and fringe benefits. Public Burden Statement We estimate that it will take an average of 55 minutes to complete this collection,including time for reviewing instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information.If you have any comments regarding these estimates or any other aspect of this collection,including suggestions for reducing this burden,send them to the Administrator,Wage and Hour Division,ESA,U.S.Department of Labor,Room S3502,200 Constitution Avenue,N.W. Washington,D.C.20210. - (over) ------- -?+•••:: -i'i:,'8 v+:d..vs d..h.ls:;'la,,.H...crtvnas..sa:zc�u.....c. U.S. Department of Labor PAYROLL Employment Standards Administration , Wage and Hour Division (For Contractors Optional Use; See Instructions at www.dot.gov lesalwhd/formslwh347instr.htm)c z.,., , ,,,,,,,„. ri., r..: ..,. Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. Rev. Dec.2008 NAME OF CONTRACTOR i] OR SUBCONTRACTOR ❑ ADDRESS OMB NO.: 1215-0149 D.P. CO., INC. 1681 EXPO LANE, SUITE A, INDIANAPOLIS, IN 46214 Expires: 12/31/2011 PAYROLL NO. FOR WEEK ENDING PROJECT AND LOCATION PROJECT OR CONTRACT NO 000038 8/22/2010 CARMEL PERFORMING ARTS (1) (2) (3) (4)DAY AND DATE (5) (6) (7) (6) --- (9) y S M T W T F S DEDUCTIONS _ NET NAME AND INDIVIDUAL IDENTIFYING NUMBER 1 C o GROSS WITH- WAGES (e.g.,LAST FOUR DIGITS OF SOCIAL SECURITY a WORK )-: 22 16 17 18 19 20 21 TOTAL RATE AMOUNT HOLDING TOTAL PAID NUMBER)OF WORKER 2k:B CLASSIFICATION ° HOURS WORKED EACH DAY HOURS OF PAY EARNED FICA TAX CAFETERIA NR LOAN. OTHER _DEDUCTIONS FOR WEEK 0000000004 D 686.70 02 SKILLED S 6.50 6.50 8.00 21.00 32.70 1151.26 88.07 161.73 54.93 304.73 846.53 0000000005 D 242.60 04 SKILLED S 8.00 B.00 8.00 6.00 8.00 38.00 32.70 1242.60 95.06 94.27 51.29 240.62 1001.98 0000000068 D 392.40 51 SKILLED S 10.50 1.50 12.00 32.70 392.40 30.02 5.78 17.26 53.06 339.34 0000000067 0 412.00 02 SKILLED S 10.50 1.50 12.00 32.70 412.00 30.02 17.26 47.28 364.72 O / S 0 S S 0 S While completion of form WH-347 is optional,it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R.°°3.3,5.5(a).The Copeland Act (40 U.S.C.°3145)contractors and subcontractors performing work on Federally financed or assisted construction contracts to"furnish weekly a statement with respect to the wages paid each employee during the preceding week."U.S.Department of Labor(DOL)regulations at 29 C.F.R.°5.5(a)(3)(ii)require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project,accompanied by a signed"Statement of Compliance"indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis-Bacon prevailing wage rate for the work performed.DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages and fringe benefits. Public Burden Statement We estimate that it will take an average of 55 minutes to complete this collection,including time for reviewing instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information.If you have any comments regarding these estimates or any other aspect of this collection,including suggestions for reducing this burden,send them to the Administrator,Wage and Hour Division,ESA,U.S.Department of Labor,Room S3502,200 Constitution Avenue,N.W. Washington,D.C.20210. - (over) - - Date 08/30/2010 (b)WHERE FRINGE BENEFITS ARE PAID IN CASH KEVIN BLUME PRESIDENT ❑ -Each laborer or mechanic listed in the above referenced payroll has been paid, (Name of Signatory Party) (Title) as indicated on the payroll,an amount not less that the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed do hereby state: in the contract,except as noted in Section 4(c)below. (1)That I pay or supervise the payment of the persons employed by (c)EXCEPTIONS D.P. CO.. INC. on the (Contractor or Subcontractor) EXCEPTION(CRAF1) EXPLANATION CARMEL PERFORMING ARTS ;that during the payroll period commencing on the (Building or Work) 16 day of August ,2010,and ending the 22 day of August , 2010, — — all persons employed on said project have been paid the full weekly wages earned,that no rebates have been or will be made either directly or indirectly to or on behalf of said D.P. CO., INC. from the full (Contractor or Subcontractor) weekly wages earned by any person and that no deductions have been made either directly or indirectly from the full wages earned by any person,other than permissible deductions as defined in Regulations,Part _ 3(29 CFR Subtitle A),issued by the Secretary of Labor under the Copeland Act,as amended(48 Stat.948, 63 Start,108,72 Stat.967;76 Stat.357;40 U.S.C.2 3145),and described below: _ FICA,FEDERAL,WITHHOLDING TAX.INSURANCE REMARKS: (2)That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete;that the wage rates for laborers of mechanics contained therein are not less that the applicable wage rates contained in any wage determination incorporated into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work he performed. (3)That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of NAME AND TITLE SIGNATURE Apprenticeship and Training,United States Department of Labor,of if no such recognized agency exists in a State,are registered with the Bureau of Apprenticeship and Traning,United States Department of Labor. KEVIN BLUME/PRESIDENT THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR (4)That: SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION.SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE ` 31 OF THE UNITED STATES CODE (a)WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS,FUNDS,OR PROGRAMS ❑ - in addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees,except as noted in Section 4(c)below. D. P. CO., INC. DIVERSIFIED PAINTING r O,, INC. 1681 Expo Lane, Indianapolis. IN 46214 (317) 209-9899 fax (317)209-9886 3 , ,...?. September 23, 2010 il 5 City of Carmel Redevelopment Commission Re: Trade Secret Notice -REGIONAL PERFORMING ARTS CENTER ("Project") Dear City of Carmel Redevelopment Commission • Enclosed is the certified payroll you have requested for the above-referenced project. Diversified Painting Co., Inc. is supplying this information for the exclusive review of CSO j ARCHITECTS and the City of Carmel Redevelopment Commission_. This information is not to be shared, copied or passed along to any other parties without the written permission of Diversified Painting Co., Inc. This information is viewed as confidential employee information and contains trade secrets. Anyone forwarding or transmitting this information without written permission by Diversified Painting Co.,Inc.will be held responsible to the fullest extent permitted by Indiana and federal law. Furthermore, pursuant to the Indiana Public Access Counselor, this information is not disclosable under the Indiana Open Records Act. If you have any questions on this matter,please contact me. E Very t yours, c- evin Blume President 5 . • �; U.S. Department of Labor PAYROLL W : , 0 Employment Standards Administration (For Contractor's Optional Use; See Instructions at www.dol.gov/esa/whd/forms/wh347instr.htm) Wage and Hour Division w say ,�cssq Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. Rev.Dec.2008 - NAME OF CONTRACTOR El OR SUBCONTRACTOR E ADDRESS OMB No.: 1215-0149 D.P. CO., INC. 1681 EXPO LANE, SUITE A, INDIANAPOLIS, IN 46214 Expires: 12/31/2011 PAYROLL NO. FOR WEEK ENDING PROJECT AND LOCATION PROJECT OR CONTRACT NO 000039 8/29/2010 CARMEL PERFORMING ARTS (1) (2) (3) (4)DAY AND DATE (5) (6) (7) (9) (8) NAME AND INDIVIDUAL IDENTIFYING NUMBER 2 Q t;' S M T W T F $ DEDUCTIONS NET GROSS WITH- WAGES (e.g.,LAST FOUR DIGITS OF SOCIAL SECURITY E`�% WORK F 29 23 24 25 26 27 28 TOTAL RATE AMOUNT HOLDING TOTAL PAID NUMBER)OF WORKER =5 88 CLASSIFICATION ° HOURS WORKED EACH DAY HOURS OF PAY EARNED FICA TAX CAFETERIA A/R LOANS OTHER DEDUCTIONS FOR WEEK 0000000064 882.00 04 UNSKILLED 3 • 8.00 8.00 8.00, 8.00 8.00 40.00 22.05 882.00 67.47 40.18 44.54 152.19 729.81 0000000057 980.40 05 SEMI SKILLED • 8.00 8.00 8.25 8.00 7.75 40.00 24.51 980.40 75.00 72.77 49.51 197.28 783.12 0000000023 .182.61 02 SEMI SKILLED 5.50 5.50 36.76 • 8.00 8.00 7.50 8.00 8.00 0.50 40.00 24.51 1182.61 90.47 106.33 59.72 256.52 926.09 0000000070 0 790.81 00 SEMI SKILL 1 S 8.00 8.00 8.00 7.00 31.00 25.51 790.81 583.66 0000000047 0 05 SEMI SKILL 1 S 8.00 8.00 25.51 1011.44 77.38 49.07 51.08 177.53 833.91 0000000007 o 1020.40 05 SEMI SKILL 1 S 8.00 8.00 8.00 8.00 8.00 40.00 25.51 1020.40 78.06 50.42 51.53 180.01 840.39 0000000038 L060.40 05 SEMI SKILL 2 G S 8.00 8.00 8.00 8.00 8.00 40.00 26.51 1060.40 81.12 56.42 48.69 186.23 874.17 0000000056 p L060.40 05 SEMI SKILL 2 iS 8.00 8.00 8.25 8.00 7.75 40.00 26.51 � 1060.40 81.12 56.42 53.55 191.09 869.31 While completion of form WH-347 is optional,it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R."°3.3,5.5(a).The Copeland Act (40 U.S.C.°3145)contractors and subcontractors performing work on Federally financed or assisted construction contracts to"furnish weekly a statement with respect to the wages paid each employee during the preceding week."U.S.Department of Labor(DOL)regulations at 29 C.F.R.°5.5(a)(3)(ii)require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project,accompanied by a signed"Statement of Compliance"indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis-Bacon prevailing wage rate for the work performed.DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages and fringe benefits. Public Burden Statement We estimate that it will take an average of 55 minutes to complete this collection,including time for reviewing instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information.If you have any comments regarding these estimates or any other aspect of this collection,including suggestions for reducing this burden,send them to the Administrator,Wage and Hour Division,ESA,U.S.Department of Labor,Room S3502,200 Constitution Avenue,N.W. Washington,D.C.20210. (over) U.S. Department of Labor e PAYROLL r:2 z,-ln i if n Employment Standards Administration (For Contractor's Optional Use; See Instructions at www.dol"gov/esa/whd/forms/wh347instr.htm) .t,s t-1,.., Dl-2?P , Wage and Hour Division t; Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. Rev.Dec.2008 - NAME OF CONTRACTOR ❑ OR SUBCONTRACTOR ❑ ADDRESS OMB No.: 1215-0149 D.P. CO., INC. 1681 EXPO LANE, SUITE A, INDIANAPOLIS, IN 46214 Expires: 12/31/2011 PAYROLL NO. FOR WEEK ENDING PROJECT AND LOCATION PROJECT OR CONTRACT NO 000039 8/29/2010 CARMEL PERFORMING ARTS (1) (2) (3) (4)DAY AND DATE (5) (6) (7) (9) (8) DEDUCTIONS NET NAME AND INDIVIDUAL IDENTIFYING NUMBER 1 a c S M T W T F S GROSS WITH- WAGES (e.g.,LAST FOUR DIGITS OF SOCIAL SECURITYog 6' WORK 29 23 , 24, 25 26 27 28 TOTAL RATE AMOUNT HOLDING TOTAL PAID NUMBER)OF WORKER 2 B CLASSIFICATION° HOURS WORKED EACH DAY HOURS OF PAY EARNED FICA TAX CAFETERIA A/R LOANS OTHER DEDUCTIONS FOR WEEK 0000000069 0 883.81 00 SEMI SKILL 4 S 8.00 8.00 8.00 7.00 31.00 28.51 883.81 67.62 82.57 44.63 194.82 688.99 0000000005 1651.35 04 SKILLED 0.25 6.75 7.00 49.05 S 8.00 8.00 8.00 8.00 7.75 0.25 40.00 32.70 1651.35 126.32 155.59 69.27 351.18 1300.17 0000000068 0 794.40 01 SKILLED S 9.00 8.00 5.00 22.00 32.70 794.40 55.03 47.38 31.65 134.06 660.34 0000000067 0 703.05 02 SKILLED S 8.50 8.00 5.00 21.50 32.70 703.05 53.78 34.40 30.93 119.11 583.94 0 / S 0 / S 0 / S 0 / S While completion of form WH-347 is optional,it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R.0°3.3,5.5(a).The Copeland Act (40 U.S.C.°3145)contractors and subcontractors performing work on Federally financed or assisted construction contracts to"furnish weekly a statement with respect to the wages paid each employee during the preceding week."U.S.Department of Labor(DOL)regulations at 29 C.F.R.°5.5(a)(3)(ii)require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project,accompanied by a signed"Statement of Compliance"indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis-Bacon prevailing wage rate for the work performed.DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages and fringe benefits. Public Burden Statement We estimate that it will take an average of 55 minutes to complete this collection,including time for reviewing instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information.If you have any comments regarding these estimates or any other aspect of this collection,including suggestions for reducing this burden,send them to the Administrator,Wage and Hour Division,ESA,U.S.Department of Labor,Room S3502,200 Constitution Avenue,N.W. Washington,D.C.20210. (over) Date 09/07/2010 (b)WHERE FRINGE BENEFITS ARE PAID IN CASH I, KEVIN BLUME PRESIDENT ❑ -Each laborer or mechanic listed in the above referenced payroll has been paid, (Name of Signatory Party) (Title) as indicated on the payroll,an amount not less that the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed do hereby state: in the contract,except as noted in Section 4(c)below. (1)That I pay or supervise the payment of the persons employed by (c)EXCEPTIONS D.P. CO., INC. on the (Contractor or Subcontractor) EXCEPTION(CRAFT) EXPLANATION CARMEL PERFORMING ARTS ;that during the payroll period commencing on the (Building or Work) 23 day of August ,2010,and ending the 29 day of August , 2010, all persons employed on said project have been paid the full weekly wages earned,that no rebates have been or will be made either directly or indirectly to or on behalf of said D.P. CO., INC. from the full (Contractor or Subcontractor) weekly wages earned by any person and that no deductions have been made either directly or indirectly from the full wages earned by any person,other than permissible deductions as defined in Regulations,Part 3(29 CFR Subtitle A),issued by the Secretary of Labor under the Copeland Act,as amended(48 Stat.948, 63 Start,108,72 Stat.967;76 Stat.357;40 U.S.C.4 3145),and described below: FICA,FEDERAL,WITHHOLDING TAX,INSURANCE REMARKS: (2)That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete;that the wage rates for laborers of mechanics contained therein are not less that the applicable wage rates contained in any wage determination incorporated into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work he performed. (3)That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of S ••TUBE NAME AND TITLE Apprenticeship and Training,United States Department of Labor,of if no such recognized agency exists in a State,are registered with the Bureau of Apprenticeship and Traning,United States Department of Labor. KEVIN BLUME/PRESIDENT THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEM Y SUBJECT THE CONTRACTOR OR (4)That SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION.SE�TION 1001 OF TITLE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE (a)WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS,FUNDS,OR PROGRAMS ❑ - in addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees,except as noted in Section 4(c)below. - D P. CO., INC. DIVERSIFIED PAINTING CO., INC. 1681 Expo Lane, Indianapolis. IN 46214 (.?'._7) 209-9899 fax (317)209-9886 September 23, 2010 City of Carmel Redevelopment Commission Re: Trade Secret Notice -REGIONAL PERFORMING ARTS CENTER ("Project") Dear City of Carmel. Redevelopment Commission • Enclosed is the certified payroll you have requested for the above-referenced project. Diversified Painting Co., Inc. is supplying this information for the exclusive review of CSO ARCHITECTS and the City of Carmel Redevelopment Commission . This information is not to be shared, copied or passed along to any other parties without the written permission of Diversified Painting Co., Inc. This information is viewed as confidential employee information and contains trade secrets. Anyone forwarding or transmitting this information without written permission by Diversified Painting Co.,Inc.will be held responsible to the fullest extent permitted by Indiana and federal law. Furthermore, pursuant to the Indiana Public Access Counselor, this information is not disclosable under the Indiana Open Records Act. If you have any questions on this matter,please contact me. Very truly yours, Kevin Blume President U.S. Department of Labor PAYROLL Employment Standards Administration (For Contractor's Optional Use; See Instructions at www.dol.gov/esa/whd/forms/wh347instr.htm)r r :.w a , L. „ s. Wage and Hour Division Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. Rev. Dec.2008 ------- --- NAME OF CONTRACTOR it OR SUBCONTRACTOR ❑ ADDRESS OMB No 1215-0149 D.P. CO., INC. 1681 EXPO LANE, SUITE A, INDIANAPOLIS, IN 46214 Expires: 12/31/2011 PAYROLL NO. FOR WEEK ENDING PROJECT AND LOCATION PROJECT OR CONTRACT NO 000040 9/05/2010 CARMEL PERFORMING ARTS (1) (2) (3) (4)DAY AND DATE (5) (6) (7) (8) ----------------- (9) t S M T W T F S DEDUCTIONS _____ NET NAME AND INDIVIDUAL IDENTIFYING NUMBER 52 o ce GROSS WITH- -7 WAGES o (e.g.,LAST FOUR DIGITS OF SOCIAL SECURITY.6,- s WORK F 05 30 31 01 02 03 04 TOTAL RATE AMOUNT HOLDING -I0 JAL PAID NUMBER)OF WORKER 8k.S CLASSIFICATION° HOURS WORKED EACH DAY HOURS OF PAY EARNED FICA TAX CAFETERIA AIR LOAN. OTHER DEDUCTIONS FOR WEEK 0000000064 D 937.13 04 UNSKILLED 3 7.00 7.00 33.07 S 9.00 10.00 10.00 3.00 32.00 22.05 1122.89 85.90 76.32 56.71 218.93 903.96 0000000057 D .004.91 05 SEMI SKILLED 6.00 6.00 36.76 S 9.00 10.00 10.00 3.00 32.00 24.51 1213.55 92.84 124.66 61.28 278.78 934.77 0000000023 O 931.38 02 SEMI SKILLED S 9.00 10.00 10.00 9.00 38.00 24.51 931.38 71.26 68.65 47.04 186.95 744.43 0000000070 O 969.38 00 SEMI SKILL 1 S 9.00 10.00 10.00 9.00 38.00 25.51 969.38 74.16 151.35 48.95 274.46 694.92 0000000047 0 229.59 05 SEMI SKILL 1 S 9.00 9.00 25.51 758.55 58.03 14.32 38.31 110.66 647.89 0000000007 229.59 -- - - --�-------_-_---- 05 SEMI SKILL 1 _ S 9.00 9.00 25.51 1274.85 97.53 88.58 64.38 250.49 1024.36 0000000038 0 1086.91 05 SEMI SKILL 2 6.00 6.00 39.76 $ 9.00 10.00 10.00 3.00 32.00 26.52_,///1311.55 100.34 94.09 - 59.79 254.22 1057.33 0000000056 0 L086.91 05 SEMI SKILL 2 6.00 6.00 39.76 S 9.00 10.00 10.00 3.00 32.00 26.51/1311.55 100.34 94.09 66.23 260.66 1050.89 While completion of form WH-347 is optional,it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R.°°3.3,5.5(a).The Copeland Act (40 U.S.C.°3145)contractors and subcontractors performing work on Federally financed or assisted construction contracts to"furnish weekly a statement with respect to the wages paid each employee during the preceding week."U.S.Department of Labor IDOL)regulations at 29 C.F.R.°5.5(a)(3)(n)require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project,accompanied by a signed"Statement of Compliance"indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis-Bacon prevailing wage rate for the work performed.DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages arid fringe benefits. Public Burden Statement We estimate that it will take an average of 55 minutes to complete this collection,including time for reviewing instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information.It you have any comments regarding these estimates or any other aspect of this collection,including suggestions for reducing this burden,send them to the Administrator,Wage and Hour Division,ESA,U.S.Department of Labor,Room S3502,200 Constitution Avenue,N.W. Washington,D.C.20210. (over) U.S. Department of Labor PAYROLL Employment Standards Administration (For Contractor's Optional Use; See Instructions at w .dol.gov/esa/whd/forms/wh347instr.htm)r ` Wage and Hour Division ww ----- Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. Rev.Dec.2008 NAME OF CONTRACTOR ❑ OR SUBCONTRACTOR CI ADDRESS OMB No: 1215-0149 D.P. CO., INC. 1681 EXPO LANE, SUITE A, INDIANAPOLIS, ]:N 46214 Expires: 12/31/2011 PAYROLL NO. FOR WEEK ENDING PROJECT AND LOCATION PROJECT OR CONTRACT NO 00004.0 9/05/2010 CARMEL PERFORMING ARTS (1) (2) (3) (4)DAY AND DATE (5) (6) (7) ----- (8) --- ---- (9) y S M T W T FS DEDUCTIONS NET NAME AND INDIVIDUAL IDENTIFYING NUMBER s o o GROSS WITH- WAGES (e.g.,LAST FOUR DIGITS OF SOCIAL SECURITY og s WORK F 05 30 31 01 02 03 04 TOTAL RATE AMOUNT HOLDING TOTAL PAID NUMBER)OF WORKER 8, CLASSIFICATION ° HOURS WORKED EACH DAY HOURS OF PAY EARNED FICA TAX CAFETERIA NR LOAN. OTHER DEDUCTIONS FOR WEEK 0000000069 083.38 O 00 SEMI SKILL 4 9.00 10.00 10.00 9.00 — 38.00 28.51 1083.38 82.88 112.51 54.71 250.10 833.28 0000000005 0 226.25 04 SKILLED 9.00 9.50 10.00 9.00 37.50 32.70 1226.25 93.81 91.82 50.57 236.20 990.05 0 0 S --i — O $ 0 0 0 While completion of form WH-347 is optional,it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R.°°3.3,5.5(a).The Copeland Act (40 U.S.0°3145)contractors and subcontractors performing work on Federally financed or assisted construction contracts to"furnish weekly a statement with respect to the wages paid each employee during the preceding week.'U.S.Department of Labor(DOL)regulations at 29 C.F.R.°5.5(a)(3)(ii)require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project,accompanied by a signed"Statement of Compliance"indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis-Bacon prevailing wage rate for the work performed,DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages and fringe benefits. Public Burden Statement We estimate that it will take an average of 55 minutes to complete this collection,including time for reviewing instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information.If you have any comments regarding these estimates or any other aspect of this collection,including suggestions for reducing this burden,send them to the Administrator,Wage and Hour Division,ESA,U.S.Department of Labor,Room S3502,200 Constitution Avenue,N.W. Washington,D.C.20210. • — — (over) — — Date 09/09/2010 (b)WHERE FRINGE BENEFITS ARE PAID IN CASH t, xevita BLUM& PRESIDENT ❑ -Each laborer or mechanic listed in the above referenced payroll has been paid, (Name of Signatory Party) (Title) as indicated on the payroll,an amount not less that the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed do hereby state: in the contract,except as noted in Section 4(c)below. (1)That I pay or supervise the payment of the persons employed by (c)EXCEPTIONS D.P. CO., INC. on the (Contractor or Subcontractor) EXCEPTION(CRAP]I EXPLANATION CARMEL PERFORMING ARTS ;that during the payroll period commencing on the (Building or Work) 30 day of August ,2010,and ending the 05 day of September , 2010, all persons employed on said project have been paid the full weekly wages earned,that no rebates have been or will be made either directly or indirectly to or on behalf of said D.P. CO., INC. from the full — . — (Contractor or Subcontractor) weekly wages earned by any person and that no deductions have been made either directly or indirectly from the full wages earned by any person,other than permissible deductions as defined in Regulations,Part 3(29 CFR Subtitle A),issued by the Secretary of Labor under the Copeland Act,as amended(48 Stat.948, 63 Start,108,72 Stat.967;76 Stat.357;40 U.S.C.°3145),and described below: FICA,FEDERAL,WITHHOLDING TAX,INSURANCE REMARKS: (2)That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete;that the wage rates for laborers of mechanics contained therein are not less that the applicable wage rates contained in any wage determination incorporated into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work he performed. (3)That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of NAME AND TITLE ATURE Air Apprenticeship and Training,United States Department of Labor,of if no such recognized agency exists in a State,are registered with the Bureau of Apprenticeship and Traning,United States Department of Labor. KEVIN BLUME/PRESIDENT THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEME SUBJECT THE CONTRACTDR'OR" (4)Thal: SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION.SE' TION 1001 OF TITLE 18 AND SECTION 231 OF TITLE I 31 OF THE UNITED STATES CODE • (a)WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS,FUNDS,OR PROGRAMS ❑ - in addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees,except as noted in Section 4(c)below. D. P. CO., INC. DIVERSIFIED PAINTING CO., INC. 1681 Expo Lane, Indianapolis, IN 46214 (317) 209-9899 fax (317)209-9886 14; C I September 23, 2010 Cry of Carmel Redevelopment Commission Re: Trade Secret Notice -REGIONAL PERFORMING ARTS CENTER ("Project") Dear_City of Carmel Redevelopment Commission • Enclosed is the certified payroll you have requested for the above-referenced project. Diversified Painting Co., Inc. is supplying this information for the exclusive review of CSO ;' ARCHITECTS and the — City of Carmel Redevelopment Commission . This information is not to be shared, copied or passed along to any other parties without the written permission of Diversified Painting Co., Inc. This information is viewed as confidential employee information and contains trade secrets. Anyone forwarding or transmitting this in formation without written permission by Diversified Painting Co.,Inc.will be held responsible to the fullest extent permitted by Indiana and federal law. Furthermore, pursuant to the Indiana Public Access Counselor, this information is not disclosable under the Indiana Open Records Act. If you have any questions on this matter, please contact me. Very truh-yours, - .m Blume President . ' U S Department of Labor PAYROLL - Employment Standards Administration W N�DoanUMou,D*�km (ForConi»acto�s (�pUonn| Usn; GeeinmtnmcUnnoutvmxwvdoigov/nsakwhd�ormnkwh347instr.htnm) , ��m Persons are not os"m�mmv�o"owmocm�c�nwmmnnammvn�v vu�n��arm�n»y,am/owm*mmunummr uev Dec.2008 NAME npCONTRACTOR [] OR SUBCONTRACTOR [] -�� ---' ADDRESS ------- ---�- ---�---�----� --- -----�-------�---------' D.P. CO., INC. 1681 EXPO LANE, SUITE A, INDIANAPOLIS, IN 46214 OMB No.: 1215*149 Expires: 12/31/2011 ________ __- ____-_'__� PAYROLL NO FOR WEEKENDING ----� PROJECT AND LOCATION ----- PROJECT ----� 0 0 0 0 4 1 9/12/2010 CARMEL PERFORMING ARTS nnr»wr«^«rw« --- --- (1) (2) (3) ---���^,^wo�ns (5) �� T-'-��---'----- ---'--------'----------'(�------ ` (n) ',, S T �� T l 3 -- _- � --»DEDUCTIONS DEDUCTIONS»*n--' ---'-----------�---�� wNET N�smm/wo���msw�,�N��n V� �- GROSS WITH- ] l WAGES r*o LAST rnvnuwnSopnvCvvoscvmry� & *mn« � /z 06 07 08 09 10 11 TOTAL RATE� ^Mmwr HOLDING nzmLmm NUMBER)opWORKER � . CLASSIFICATION HOURS WORKED EACH D FICA CAFETERIA NR LOAN. orxsn DEDUCTIONS FOR , ^ _ 000000006" o 06 UNSKILLED , "o ,�," -'- '___- _ '__-- v z" ."`.�"","�oom "o � ^oo. � � ' y"."" 75.78 35.42 50.02 16122 "=".`" 0000000013 o ��'--�-'------�-----��-�------��--- 02 UNSKILLED 1 " "o 8.00 30.07 10.00 10.00 10.0010.0" 40.00 20.05 79.76 ",.`` ,,",'- 217.74 824.86 0000000064 n 04 UNSKILLED 3 ---- 5.50 5.50 33.07 __ `."° ".o" ,.m^""° 2.5" 40.00 22.05/ 1063.91 81.39 67.47 53.72 ,,2", ,,^.," 000000005' 0 --�----------� 05 SEMI SKILLED 8.00 8.00 36.76-__ '/ » �.� u�0m.�m.� 40.00 24.51 /�=.52 -- =.50 139.= --------- 64.36 "301.76---m^," ^'` ~0000000023 » 02 SEMI SKILLED 8.00 8.00 36 -�- « 10.00 10.00 10.0010.00 40.00 24.51 /12`^.52 97.50 `=.`" --'--�-- --64.36 --�"281,98 992.54 992.54- 274.52 0000000063 o 03 SEMI SKILLED 8.00 8.00 36.76 -�- '--' _-- _ - 10.0010.0010.0010.00 40.00 24.51Z 1274.52 97.50 109.59 64.`" __-273.45 - 1002.07__ - 0000000070 00 SEMI SKILL 1 v "�"" "�oo ," 326.52--- ✓ _ ��"z».�`".�m.00 40.00 25.51 /!m 6.52 101.47 241.14- ---------- ,,", ----=,.-- 916.92^�,� 0000000047 ^^'^/^/» 05 SEMI SKILL 1 / ,.00 8.00 38.26 ---' S ^.mm.��.��.�| 3�0� 25.51 /`m".m 102.55 98.43 67.70 268.68 . 1071.82 While completion of form WH-347 is optional,it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R.'3.3,5.5(a).The Copeland Act--- (40 U.S.C.'3145)contractors and subcontractors performing work on Federally finance or assisted construction contracts to"lurnish weekly a statement with respecl to the wages paid each employee during the preceding wee .'ux.oenomnentmLam,(omVrewmm=at muF.u^swmpXa require contractors*submit weekly o copy mall payrolls to the Federal agency contracting for or financing the construction project,accompanied byv signed"Statement moomplionoe indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis-Bacon prevailing wage rate for the work performed.DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages arid fringe benefits. . Public Burden Statement We esfimate that it will take an average of 55 minutes to complete this collection,including time for reviewing instructions,searching existing data sources,gathering and maintaini the data neede and compl :ng*m°°iew/ngmo*ulectio"u/oformatio".//nwhwm any comments regarding these estimates o,any other aspect m this collection,including suggestions for reducing this burden,send them*the Administrator,Wage and Hour Division,ESA,ux.Department m Labor,Room x3mu,mo Constitution Avenue,w.w. Washington,uz.00m. • -_ ___' __-__ - ----_--__ ' (over) ` ' U.S. Department of Labor PAYROLL Employment Standards Administration (For Contractor's Optional Use; See Instructions at www.doLgov/esa/whd/forms/wh347instr.htrn)f Wage and Hour Division Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. Rev. Dec.2008 NAME OF CONTRACTOR 0 OR SUBCONTRACTOR O ADDRESS OMB No.: 1215-0149 D.P. CO., INC. 1681 EXPO LANE, SUITE A, INDIANAPOLIS, IN 46214 Expires: 12/31/2011 PAYROLL NO. FOR WEEK ENDING PROJECT AND LOCATION PROJECT OR CONTRACT NO 000041 9/12/2010 CARMEL PERFORMING ARTS - ---------------- -- ---- -- - ---------- --- - (1) (2) (3) - (4)DAY AND DATE ------- (5) (6) (7) (8) (9) y S M T W T F____S __ - - DEDUCTIONS NET NAME AND INDIVIDUAL IDENTIFYING NUMBER §o o GROSS WITH- WAGES (e.g.,LAST FOUR DIGITS OF SOCIAL SECURITY g d WORK F 12 06 07 08 09 10 11 TOTAL RATE AMOUNT HOLDING TOTAL PAID NUMBER)OF WORKER =a El CLASSIFICATION ° HOURS WORKED EACH DAY HOURS PAY EARNED FICA TAX CAFETERIA A/R LOAN OTHER DEDUCTIONS FOR WEEK 0000000038 0 L378.52 05 SEMI SKILL 2 8.00 8.00 39.76 $ 10.00 10.00 10.0010.00 40.00 26.51 1378.52 105.46 104.13 64.76 274.35 1104.17 0000000056 0 L378.52 05 SEMI SKILL 2 8.00 8.00 39.76 $ 10.00 10.00 10.0010.00 40.00, 26.51 1378.52 105.46 104.13 69.62 279.21 1099.31 0000000069 0 .482.52 00 SEMI SKILL 4 8.00 8.00 42.76 $ 10.00 10.00 10.0010.00 40.00 28.51 1482.52 113.42 174.97 74.87 363.26 1119.26 0000000005 O 1688.14 04 SKILLED 7.75 7.75 49.05 $ 10.00 10.00 9.7510.00 0.25 40.00 32.70 1688.14 129.14 161.11 70.89 361.14 1327.00 0 0 0 0 While completion of form WH-347 is optional,it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R.-3.3,5.5(a).The Copeland Act (40 U.S.C.°3145)contractors and subcontractors performing work on Federally financed or assisted construction contracts to"furnish weekly a statement with respect to the wages paid each employee during the preceding week."U.S.Department of Labor(DOL)regulations at 29 C.F.R.°5.5(a)(3)(ii)require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project,accompanied by a signed"Statement of Compliance"indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis-Bacon prevailing wage rate for the work performed.DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages and fringe benefits. Public Burden Statement We estimate that it will take an average of 55 minutes to complete this collection,including time for reviewing instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information.If you have any comments regarding these estimates or any other aspect of this collection,including suggestions for reducing this burden,send them to the Administrator,Wage and Hour Division,ESA,U.S.Department of Labor,Room S3502.200 Constitution Avenue,N.W. Washington,D.C.20210. - - (over) - - ----- - - Date (b)WHERE FRINGE BENEFITS ARE PAID IN CASH KEVIN BLUME PRESIDENT C 1 -Each laborer or mechanic listed in the above referenced paytoll has been paid, (Name 01 signatory Party) (Title) as indicated on the payroll,an amount not less that the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed do hereby state: in the contract,except as noted in Section 4(c)below. (1)That I pay or supervise the payment of the persons employed by (c)EXCEPTIONS --__— D.P. CO., INC. on the -- — i (Contractor or Subcontractor) EXCEPTION(CRAFT) EXPLANATION CARMEL_PERFORMING ARTS ;that during the payroll period commencing on the — -—' -- —(Building or Work) —_06__ day of September ,2010,and ending the 12 day of September , 2010, -- —— — —all persons employed on said project have been paid the full weekly wages earned,that no rebates have been or will be made either directly or indirectly to or on behalf of said -- -------D.P. CO., INC. ----- from the full (Contractor or Subcontractor) weekly wages earned by any person and that no deductions have been made either directly or indirectly from the full wages earned by any person,other than permissible deductions as defined in Regulations,Part _ 3(29 CFR Subtitle A),issued by the Secretary of Labor under the Copeland Act,as amended(48 Stat.948, 63 Start,108,72 Stat.967;76 Stat.357;40 U.S.C.°3145),and described below: FICA FEDERAL,WITHHOLDING TAX,INSURANCE REMARKS (2)That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete;that the wage rates for laborers of mechanics contained therein are not less that the applicable wage rates contained in any wage determination incorporated into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work he performed. (3)That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of NAME AND TITLE IGNAT Apprenticeship and Training,United States Department of Labor,of if no such recognized agency exists in a State,are registered with the Bureau of Apprenticeship and Traning,United States Department of Labor. KEVIN BLUME/PRESIDENT _ m THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEM••T •AY SUBJECT THE CONTRACTOR OR (4)That SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. CTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE (a)WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS,FUNDS,OR PROGRAMS ❑ - in addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees,except as noted in Section 4(c)below.