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HomeMy WebLinkAboutGIBRALTAR CONSTRUCTION CORP- 002755- 3/22/2012 CARMEL REDEVELOPMENT COMMISSION 002755 Gibraltar Construction Corp Check: 2755 2932 N. Webster Ave. Date: 3/22/2012 Indianapolis, IN 46219 Vendor: GIBR1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paic 3-11 50,435.00 50,435.00 0.00 0.00 50,435.0C P47 Lofts Streetscape 50,435.00 50,435.00 0.00` 0.00 50,435.0C K*srTHEAtyi-o DOCUMENT SE6URIf • .EATFi4CTIVATED. HT UMB FRikrjst rADD fr'ioT L 4Ei_Th TyXk'iTURES INCL DE 5•SEE EtACK FOR DETAILS SbOE pt�t Carmel Redevelopment Commission i ® 30 West Mam Street REGIONS 002755 20.1421/740' ® ' L. 1 Suite 220 o`i`mE t Carmel; IN 46032 TRI 2755 DATE AMOUNT, I , 3/22/2012 **********50,43500 PAY THE SUM OFFIFTY THOUSAND FOUR HUNDRED THIRTY FIVE DOLLARS AND NO CENTS ******** TO THE ORDER OF Gibraltar Construction,Corp 2932 N:'Webster Ave. t SENSt Indianapolis,"IN 46219 's�A 000 275511' 1:0740 L4 2 L31: 00875041 111' CARMEL REDEVELOPMENT COMMISSION 002755 Gibraltar Construction Corp Check: 2755 2932 N. Webster Ave. Date: 3/22/2012 Indianapolis, IN 46219 Vendor: GIBR1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 3-11 50,435.00 50;435.00 0.00 0.00 50,435.00 P47 Lofts Streetscape 50,435.00 50,435.00 0.00 0.00 50,435.00 ;11-52 COMPUTEREASE FORMS DIVISION(877)577-5791 7-37228 4`? ItAIA T Document G7O2ICMa M — 1992 . Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: City of Carmel PROJECT: Carmel Lofts Streetscape Parcel 47 APPLICATION NO: it Distribution to: One Civic Square PERIOD TO: 2/29/12 OWNER ❑ Carmel, IN 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT ❑ Gibraltar Construction Corp 2/4/11 2932 N.Webster Ave. PROJECT NOS: / / CONTRACTOR ❑ Indianapolis, IN 46219 VIA ARCHITECT: FIELD ❑ CSO Architects, Inc. CONTRACT FOR: Parcel 47-Carmel Lofts Streetscape ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor cep lies that to the best of the Contractor's kno,k,ledge information and below, in connection t.nth th Contract. belief the Work covered by thi pplication for Payment has been completed in accordance t:�ith the Application is made for payment, as shown below, . Contract Documents, that a at aunts have been paid by the Contractor for Work for which previous Continuation Sheet, AIA Document 0703,is attached Certificates for Payment 1/-re/issued and payments received from the Owner, and that con-em 1.ORIGINAL CONTRACT SUM S 1,373,700.00 payment shown herein is 4 v r.te. 2. Net change by Change Orders 5 270,978.00 CONTRACTOR: Gibralt41Construction Corp 3.CONTRACT SUM TO DATE(Line I ±2) 3 1,644,678.00 By: �I 4 , Date: e:2-""�1/�`2 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,644,678.00 State of: �,,,) Pr'��, BRIAN 5.RETAINAGE: County of: .,` B'RIAN . MICBRIDE a, %of Completed Work Subscribed a . a f.ti L�l - r-S o ancOCk Ccun' ' 20,000.00 / I' / ��ri� �r�V Comm. s 11-29-2017 (CoLutnn D+Eon G703) $ me this ..y of �"� % / 0 b. %of Stored Material Notary Public: - rp I?h CommISSion # 611862 (Column F on G703) $ My Coin if sion expire . e ' Total Retrinage(Lines 5a+5b or Total in Column I of G703).. $ CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 1,624,678.00 In accordance with the Contract Documents, based on on-site observations and the data comprising �f this application, the Construction Manager and Architect certify to the Owner that to the best of their V (Line I Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated, the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT S 1,574,243.00 accordance with the Contract Documents,and the Contractor is entitled to payment of the ADIOLJNT (Line 6 from prior Certificate) CER ILt UaD. 8.CURRENTPAYMENT DUE $ 50,435.00 AMOUNT CERTIFIED $50,4,66.Do 9.BALANC ETD FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied. Initial all figures on this 20,000.00 Application aril on d y - 'nuati an Sh et that are changed to conform with the amount centred.) (Lines .',less Line 6) S CONSTRUCTIk /G• ': e Of By: ✓...� / Date: Z Z1 CHANGE ORDER SUM3\L RY I ADDITIONS DEDUCTIONS ARCHITECT: CSO&A pr �/ Total chap ots approved.in previous months by Owner S 5 By: �' , ` Date: `7Z91(Z-- Total appr oved this Month I S S I This Certificate is not neotiabie. The AMOUNT CER1TFIT;D is payable only to the Contractor. TOTALS S t I named herein. Issuance. payment and acceptance of payment are without prejudice to any rights of NET CH_� GES by Change Order S the Owner or Contractor under this Contract. CAUTION: lbu should sign an original AIA Contract Document, on which this text appears in RED. An original assures that chances will not be obscured. _ Alia Docum�nlG702/CMaTv—1992. Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties. CONTINUATION SHEET Page 2 of 4 - APPLICATION NO. : 12 ' APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is APPLICATION DATE: 2/24/2012 attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where PERIOD TO: 2/24/2012 variable retainage for line items may apply. ARCHITECT'S PROJECT NO. : A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE DESCRIPTION OF WORK SCHEDULED VALUE FROM PREVIOUS FINISH (IF VARIABLE NO. APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) (C-G) RATE) (D+E) DORE) (D+E+F) 1 Allowance No. 1 - Base Bid Contingency $5,000.00 $5,000.00 $5,000.00 100°k - 2 Allowance No. 2 -Winter Conditions $30,000.00 $30,000.00 $30,000.00 100% - 3 Allowance No. 3 -Alternate 1 Contingency $5,000.00 $5,000.00 $5,000.00 100% - 4 Allowance No. 4-Alternate 2 Contingency $5,000.00 $5,000.00 $5,000.00 100% - 5 Allowance No. 5-Alternate 3 Contingency $5,000.00 $5,000.00 $5,000.00 100% - 6 Allowance No. 6 -Alternate 4 Contingency $5,000.00 $5,000.00 $5,000.00 100% - 7 Bond $18,500.00 $18,500.00 $18,500.00 100% - 8 General Conditions $86,000.00 $86,000.00 $86,000.00 100% - 9 Site Clearing/Selective Site Demo $29,200.00 $29,200.00 $29,200.00 100% - 10 Earthwork $114,500.00 $114,500.00 $114,500.00 100% - 20,000.00 11 Stucural Soil $7,800.00 $7,800.00 $7,800.00 100% - 12 Erosion/Sedimentation Control $500.00 $500.00 $500.00 100% - 13 Water Distribution $48,200.00 $48,200.00 $48,200.00 100% - 14 Storrs Drainage $139,700.00 $139,700.00 $139,700.00 100% - 15 Asphalt Paving $16,900.00 $16,900.00 $16,900.00 100% - 16 Cast.in-Place Concrete-Mt'I $7,750.00 $7,750.00, $7,750.00 100% - 17 Castro-Place Concrete-Labor $6,350.00 $6,350.00 $6,350.00 100% - 18 Trench Drains- Mt'l $7,500.00 $7,500.00 $7,500.00 100% - 19 Trench Drains- Labor $2,300.00 $2,300.00 $2,300.00 100% - 20 Concrete Paving $156,454.00 $156,454.00 $156,454.00 100% - 21 Concrete Footing and Walls $43,900.00 $43,900.00 $43,900.00 100% - 22 ,Pavia Joint Sealants $3,700.00 $3,700.00 $3,700.00 100% - 23 Unit Paver-Concrete $79,000.00 $79,000.00 $79,000.00 100% - 24 PeFneable Unit Paving System -Concrete $65,000.00 $65,000.00 $65,000.00 100% - 25 Sevumental Rataining Wall $25,000.00 $25,000.00 $25,000.00 100% - CONTINUATION SHEET Page 3 of 4 - APPLICATION NO. : 12 APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is APPLICATION DATE: 2/24/2012 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where PERIOD TO: 2/24/2012 variable retainage for line items may apply. ARCHITECT'S PROJECT NO A B C D E F G H I WORK COMPLETED MATERIALS TOTAL COMPLETED BALANCE TO ITEM FROM PREVIOUS PRESENTLY % RETAINAGE N0. DESCRIPTION OF WORK SCHEDULED VALUE AND STORED TO FINISH APPLICATION THIS PERIOD STORED(NOT IN DATE(D+E+F) (G/C) (C G) (IF VARIABLE RATE) (D+E) D OR E) 26 Bollards- Mt'l $5,050.00 $5,050.00 $5,050.00 100% - 27 Bollards-Labor $800.00 $800.00 $800.00 100% - 28 Masonry $9,000.00 $9,000.00 $9,000.00 100% - 29 Brick Masonry $7,000.00 $7,000.00 $7,000.00 100% - 30 Cast Stone $7,000.00 $7,000.00 $7,000.00 100% - _ 31 Pipe&Tube Railings-Steel $49,500.00 $49,500.00 $49,500.00 100% - 32 Water Repellants $700.00 $700.00 $700.00 100% - 33 Thermoplastic Membrane Waterproofing $76,000.00 $76,000.00 $76,000.00 100% - _ 34 High Performance Pond Coatings- Mt'I $1,000.00 $1,000.00 $1,000.00 100% - 35 High Performance Pond Coatings- Labor _ $1,000.00 $1,000.00 $1,000.00 100% - 36 Post& Panel Signs $5,300 5,300 $5,300.00 100% - 37 Fountain Structure- Mt'l $28,100 28,100 $28,100.00 100% - . 38 Fountain Structure- Labor $800 800 $800.00 100% - 39 Fountain Plumbing - Mt'l $12,000 12,000 $12,000.00 100% - 40 Fountain Plumbing - Labor $3,000 3,000 $3,000.00 100% - _ 41 Electrical $223,000 223,000 $223,000.00 100% - 42 Exterior Plants $8,200 8,200 $8,200.00 100% - _ 43 Tree Gates- Mt'l $9,846 9,846 $9,846.00 100% - 44 Tree Gates - Labor $1,400 1,400 $1,400.00 100% - _ _45 Bike Racks- Mt'l $900 900 900 100% - 46 Bike Racks- Labor $600 600 600 100% - _ 47 Planters- Mt'l $9,500 9,500 9,500 100% - 48 Planters- Labor $750 750 750 100% - . 49 Change Order#1 $35,000 35,000 35,000 100% - 50 Change Order#2 $116,941 116,941 116,941 100% - CONTINUATION SHEET Page 4 of 4 APPLICATION NO. : 12 APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is APPLICATION DATE: 2/24/2012 attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts PERIOD TO: 2/24/2012 where variable retainage for line items may apply. ARCHITECT'S PROJECT NO. : A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE TO ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED AND % FINISH RETAINAGE NO. VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) (IF VARIABLE RATE) (D+E) DORE) (D+E+F) (C G) 51 Change Order#3 -$20,000 (20,000) (20,000) 100% - 52 Change Order#4 $32,386 32,386 32,386 100% - 53 Change Order#5 $59,972 59,972 59,972 100% - 54 Change Order#6 $0 - 55 Change Order#7 $8,960 8,960 8,960 100% - 56 Change Order#8 $6,571 6,571 6,571 100% - 57 Change Order#9 -$10,600 (10,600) (10,600) 100% - 58 Change Order#10 $17,769 17,769 17,769 100% - 59 Change Order#11 _ $22,156 22,156 22,156 100% - 60 Change Order#12 $1,823 1,823 1,823 100% - 61 62 63 64 65 _ 66 67 _ 68 _ 69 70 71 72 _ 73 _ 74 75 $1,644,678 $1,644,678 $0 $0 $1,644,678 100% $0 $20,000 ISA Form # 1-402 Fi AFFIDAVIT AND WAIVER OF LIEN H FINAL ® PARTIAL ® PAYMENT TO FOLLOW State of Indiana, County of Marion, SS Michael Smith being duly sworn state that he is the President of Gibraltar Construction Corp having contracted with the Owner to furnish certain materials and/or labor for a project known as Carmel Arts District Lofts Streetscape, Parcel 47 and owned by City of Carmel, Indiana. and does hereby further state on behalf of the aforementioned contractor: (PARTIAL WAIVER)that there is due from the Owner the sum of Fifty Thousand Four Hundred Thirty Five and No/100 Dollars ($50,435.00) H receipt of which is hereby acknowledged; or N the payment of which has been promised as the sole consideration 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 Dollars ( ) ❑ receipt of which is hereby acknowledged; or n the payment of which has been promised as the`•le consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THERFORE, the undersigned waives and releases unto the 0 ner of said premises, any and all lien or claim whatsoever on the above-described property and improvements there+j a•Icount of LABOR or material or both, furnished by the undersigned thereto, subject to limitations of conditions e pi re .ed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work pe/f(1r ed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Gibraltar Construction Corp By _�, Title President Tr WITNESS MY HAND AND NOTORIAL SEAL, th':/ rd day or February, 2012. (Notary Public) B R 1"S�1 R• t-"c e 1' M. ^� c 4: 1974 iNDiANA $uRcaNTAACTOA5 Assachti4O lNCOflPORatto 2 �� P,ss, of f ancock voulll UoAw1"o.-aa41 Rap■oduman Pzan'b+led) r,1y Comm. . 11-29-201 7 a.'' 1"R' io,,�` Commission # 611862 if, Q r ‘JPAL Document 6702/CMaTM — 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: APPLICATION NO: Distribution to: City of Carmel Carmel Lofts Streetscape-Parcel 47 11 One Civic Square PERIOD T0: 2/29/12 OWNER ❑ Carmel, IN 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: Gibraltar Construction CorpVIA CONSTRUCTION MANAGER: CONTRACT DATE: 214/11 ARCHITECT ❑ 2932 N.Webster Ave. PROJECT NOS: / / CONTRACTOR ❑ Indianapolis,IN 46219 VIA ARCHITECT: FIELD ❑ CSO Architects,Inc. . CONTRACT FOR: Parcel 47-Carmel Lofts Streetscape 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 t is "pplication for Payment has been completed in accordance with the Continuation Sheet,AIA Document 0703,is attached. Contract Documents, that all:.m'/ nts have been paid by the Contractor for Work for which previous 1.ORIGINAL CONTRACT SUM Certificates for Payment pre .sued—and payments received from the Owner, and that current $ 1,373,700.00 payment shown herein is n:: �. .. 2. Net change by Change Orders $ 246,999.00 CONTRACTOR: Gibralt•:i t►1. struction Corp 3.CONTRACT SUM TO DATE(Line 1 +2).. $ 1,620,699.00 By: ,A Date:47i2yi'/� 4.TOTAL COMPLETED&STORED.TO DATE(Column G on G703) $ 1,620,699.00_ State of: �+ 5.RETAINAGE: �, � �� BRIAN R. MCBRIDE a. %:of.Completed Work County of: "2,1,$1.41 {' 2s. '�� Res. 01 Hancock County Subscribed nd s. lob pie i (Cottigo p.+Eon G703) $ 20,000.00 me this �a o �^* �° y Y, � t, My Comm. E . 11-29-2017 b. %of Stored Material Notary Public • -- _ ./ p p 14 Commission # 611862 (Column F on G703) $ My.Commt s 'xptres: ! /J e y Total Retainage(Lines 5a+Sb or Total in Column I of G703).. $. CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 1,600,699.00 In accordance with the Contract Documents, based on on-site observations and the data comprising this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge;information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1,550,264.00 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERIth D. 8.CURRENT PAYMENT DUE $ 50,435.00 AMOUNT CERTIFIED $ 9.BALANCE TO FINISH,INCLUDING RETAINAGE'. ` (Attach explanation if amount certified differs from the:,amaiuirapplied.Initial all figures on this 20,000.00 Application and on tl e Continuation Sheet thAt are changed to conform with the amount cetnt(ed.) (Line 3 less Line 6) • $ -: •.. -• ,� i�--• QW ee s CoMPReseNTAri vE: By: /j',/ Date: .3/z OZ._ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: - sP Architects,Inc. Total changes approved::in previous months by Owner $ $ By: • Date: • Total approvedthis Month $ $ This Certificate is not negotiable. The AMOUNT CER'1LF1hD is payable only to the Contractor TOTALS S $ named herein. Issuance. payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ the Owner or Contractor under this Contract. • 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 G702/CMaT*'-1992.Copyright an 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA' Document is protected by U.S.Copyright Law and International Treaties. CONTINUATION SHEET Page 2 of 4 APPLICATION NO. : 11 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification, is APPLICATION DATE: 2/24/2012 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where PERIOD TO: 2/24/2012 variable retainage for line items may apply. ARCHITECT'S PROJECT NO. : A B C D I E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE TO RETAINAGE ITEM DESCRIPTION OF WORK SCHEDULED VALUE FROM PREVIOUS PRESENTLY COMPLETED AND % FINISH (IF VARIABLE NO. APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) (D+E) D OR E) (D+E+F) (C-G) RATE) 1 Allowance No. 1 -Base Bid Contingency $5,000.00 $5,000.00 $5,000.00 100% - 2 Allowance No.2-Winter Conditions $30,000.00 $30,000.00 $30,000.00 100% - _ 3 Allowance No. 3-Alternate 1 Contingency $5,000.00 $5,000.00 $5,000.00 100% - 4 Allowance No.4-Alternate 2 Contingency $5,000.00 $5,000.00 $5,000.00 100% - 5 Allowance No. 5-Alternate 3 Contingency $5,000.00 $5,000.00 $5,000.00 100% - 6 Allowance No.6-Alternate 4 Contingency $5,000.00 $5,000.00 $5,000.00 100% - 7 Bond $18,500.00 $18,500.00 $18,500.00 100% - 8 General Conditions $86,000.00 $86,000.00 $86,000.00 100% - 9 Site Clearing/Selective Site Demo $29,200.00 $29,200.00 $29,200.00 100% - 10 Earthwork $114,500.00 $114,500.00 $114,500.00 100% - 20,000.00 11 Stuctural Soil $7,800.00 $7,800.00 $7,800.00 100% - 12 Erosion/Sedimentation Control $500.00 $500.00 $500.00 100% - 13 Water Distribution $48,200.00 $48,200.00 $48,200.00 100% - 14 Storm Drainage $139,700.00 $139,700.00 $139,700.00 100% - 15 Asphalt Paving $16,900.00 $16,900.00 $16,900.00 100% - 16 Cast-in-Place Concrete-Mt'l $7,750.00 $7,750.00 $7,750.00 100% - 17 Cast-in-Place Concrete-Labor $6,350.00 $6,350.00 $6,350.00 100% - 18 Trench Drains-Mt'l $7,500.00 $7,500.00 $7,500.00 100% - _ 19 Trench Drains-Labor $2,300.00 $2,300.00 $2,300.00 100% - _ 20 Concrete Paving $156,454.00 $156,454.00 $156,454.00 100% - 21 Concrete Footing and Walls $43,900.00 $43,900.00 $43,900.00 100% - 22 Paving Joint Sealants $3,700.00 $3,700.00 $3,700.00 100% - 23 Unit Paver-Concrete $79,000.00 $79,000.00 $79,000.00 100% - 24 Permeable Unit Paving System-Concrete $65,000.00 $65,000.00 $65,000.00 100% - 25 Segmental Retaining Wall $25,000.00 $25,000.00 $25,000.00 100% - CONTINUATION SHEET Page3of4 APPLICATION NO. : 11 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification,is APPLICATION DATE: 2/24/2012 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where PERIOD TO: 2/24/2012 variable retainage for line items may apply. ARCHITECTS PROJECT NO. : A B C D E F G H I WORK COMPLETED MATERIALS ITEM TOTAL COMPLETED BALANCE TO DESCRIPTION OF WORK SCHEDULED VALUE FROM PREVIOUS PRESENTLY AND STORED TO oA FINISH RETAINAGE NO. APPLICATION THIS PERIOD STORED(NOT IN (G/C) (IF VARIABLE RATE) (p+E) DORE) DATE D+E+F) (C-G) 26 Bollards-Mt'l $5,050.00 $5,050.00 $5,050.00 100% - 27 Bollards-Labor $800.00 $800.00 $800.00 100% - 28 Masonry $9,000.00 $9,000.00 $9,000.00 100% - 29 Brick Masonry $7,000.00 $7,000.00 $7,000.00 100% - 30 Cast Stone $7,000.00 $7,000.00 $7,000.00 100% - 31 Pipe &Tube Railings-Steel $49,500.00 $49,500.00 $49,500.00 100% - 32 Water Repellants $700.00 $700.00 $700.00 100% - 33 Thermoplastic Membrane Waterproofing $76,000.00 $76,000.00 $76,000.00 100% - 34 High Performance Pond Coatings-Mt'l $1,000.00 $1,000.00 $1,000.00 100% - 35 High Performance Pond Coatings-Labor $1,000.00 $1,000.00 $1,000.00 100% - 36 Post&Panel Signs $5,300 5,300 $5,300.00 100% - 37 Fountain Structure-Mt'l $28,100 28,100 $28,100.00 100% - 38 Fountain Structure-Labor $800 800 $800.00 100% - 39 Fountain Plumbing - Mt'l $12,000 12,000 $12,000.00 100% - 40 Fountain Plumbing-Labor $3,000 3,000 $3,000.00 100% - _ 41 Electrical $223,000 223,000 $223,000.00 100% - 42 Exterior Plants $8,200 8,200 $8,200.00 100% - 43 Tree Gates-Mt'l $9,846 9,846 $9,846.00 100% - 44 Tree Gates-Labor $1,400 1,400 $1,400.00 100% - 45 Bike Racks-Mt'l $900 900 900 100% - 46 Bike Racks-Labor $600 600 600 100% - 47 Planters-Mt'l $9,500 9,500 9,500 100% - 48 Planters-Labor $750 750 750 100% - 49 Change Order#1 $35,000 35,000 35,000 100% - 50 Change Order#2 $116,941 116,941 116,941 100% - • CONTINUATION SHEET Page 4 of 4 APPLICATION NO. : 11 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification, Is APPLICATION DATE: 2/24/2012 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts PERIOD TO: 2/24/2012 where variable retainage for line items may apply. ARCHITECT'S PROJECT NO. : A B C D I E F G H I WORK COMPLETED MATERIALS TOTAL ITEM SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK FINISH VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G I C) (IF VARIABLE RATE) (D+E) DORE) (D+E+F) (C-G) 51 Change Order#3 -$20,000 (20,000) (20,000) 100% - 52 Change Order#4 $32,386 32,386 32,386 100% - 53 Change Order#5 $59,972 59,972 59,972 100% - 54 Change Order#6 $0 - 55 Change Order#7 $8,960 8,960 8,960 100% - 56 Change Order#8 $6,571 6,571 6,571 100% - 57 Change Order#9 -$10,600 (10,600) (10,600) 100% - 58 Change Order#10 $17,769 17,769 17,769 100% - 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 • 75 $1,620,699 $1,620,699 $0 $0 $1,620,699 100% $0 $20,000 ISA Form#1-402 ghAFFIDAVIT AND WAIVER OF LIEN (l FINAL ® PARTIAL ® PAYMENT TO FOLLOW State of Indiana, County of Marion, SS • Michael Smith being duly sworn state that he is the President of Gibraltar Construction Corp having contracted with the Owner to furnish certain materials and/or labor for a project known as Carmel Arts District Lofts Streetscape, Parcel 47 and owned by City of Carmel, Indiana. and does hereby further state on behalf of the aforementioned contractor: (PARTIAL WAIVER)that there is due from the Owner the sum of Fifty Thousand Four Hundred Thirty Five and No/100----- Dollars ($50,435.00)• ❑ receipt of which is hereby acknowledged; or ® the payment of which has been promised as the sole consideration 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 Dollars ( ) ❑ 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 which shall become effective upon receipt of such payment. THERFORE,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 there•;'! -• ount of LABOR or material or both,furnished by the undersigned thereto, subject to limitations of conditions e),, - •ed herein, if any;and further certifies that no other party has any claim or right to a lien on account of any work p_,7. -d or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Gibraltar Construction Corp By %�� Title President WITNESS MY HAND AND NOTORIAL SEAL, thi /%�%` 'ay`•f I February, 2012. (Notary Public) ����?✓E�� BRIAN R. MCBRIDE 0 1979 INDIANA suacoMTRActons ASSOG+ATios INGUAP6ot4TEp (I* Res. e Hancock County unaWnontee pbp+odvdwn Peo}1tblwd ® My Cc..,.... Exp. 11-29-2017 , C017=iSin # 611862 Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. � Payee rq//'✓ Ca/?s 7; CC))77 Purchase Order No. 2 Terms hi/c) , //d Y2/ Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) )10 I/ C*f e-/ Lo °ts 11/7 50 /3,.5- "z% • T, Total 50/y3.5": I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I h. :.•'ited same in accor- dance with IC 5-11-10-1.6. 3-z i , 20 1 2-- eteric-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 6 ( °'9// / ro'i5Tra C/4, CV IN SUM OF $ 2 9 32 /0 s>�P� /7,/, ��% /k .4'4 2/9 $ .50� ' 35-,00 • ON ACCOUNT OF APPROPRIATION FOR Board Members DEPT.# INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s), SG2 - /j .4`/6 ,5 H7 So 4'354X) or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 3- / 20/z Signature Executive Director Title Cost distribution ledger classification if claim paid motor vehicle highway fund Carmel Redevelopment Commission