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HomeMy WebLinkAboutM.A.B. & ASSOCIATES, INC.- 001462- 12/17/2010 CARMEL REDEVELOPMENT COMMISSION 001462 M.A.B. &Associates, Inc. Check: 1462 7648 Camelback Drive Date: 12/17/2010 Indianapolis, IN 46250 Vendor: MAB&Al Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 11 40 8,089.00 8,089.00 0.00 0.00 8,089.00 Application 11 8,089.00 8,089.00 0.00 0.00 8,089.00 lffailMfailiallaTtliSTCHECKI.HASFAIC.Q FOREDIBACKGROUNDIANDICONTAINS MUETifP,LE€SECURITi,YZEEATURES7„y-SEVE CWEOR DETA{LS 6 � PP.IS 6i UEyiC� Carmel Redevelopment Commission 30 West Main Street .A� REGIONS 0.01.4 6,2 2o-1421/7 Suite 220 4o CARMEL STRILt Carmel, IN 46032 _ 146.2 DATE AMOUNT - 12/17/2010 *************8,089.00 PAY ' THE SUM OF EIGHT THOUSAND EIGHTY NINE DOLLARS • TO THE - ORDER OF M.A.B. &Associates, Inc. 7648 Camelback Drive S�pS SE,, im Ind ianapolis, IN 46250 . gRFA..-0 .. 000 L46 2v 40740142 / 31: 0087504 L L LIi' CARMEL REDEVELOPMENT COMMISSION 001462 M.A.B. &Associates, Inc. Check: 1462 7648 Camelback Drive Date: 12/17/2010 Indianapolis, IN 46250 Vendor: MAB&Al Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paic 11 40 8,089.00 8,089.00 0.00 0.00 8,089.00 Application 11 8,089.00 8,089.00 0.00 0.00 8,089.0( .„..,„ 0 , Document 6702/CMaTM 1992 q° — Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: CA g4i.e ( 4"4-4,.. 4i T s APPLICATION NO: /.1 Distribution to: PERIOD TO: i1/30//0 OWNER ❑ O CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: , VIA C�,DgNS�jRUCTI N MMGER: CONTRACT DATE: z/�7/°7 ARCHITECT ❑ AO. Q ,f. A4JOC,.a rer, ..i C. �i(1..,_5-A if .rv, PROJECT NOS: 26//c/31 ZO / CONTRACTOR ❑ • "6V I' eau?el 13'4r 5(r b,/.11; v•1.LAp.I,s ,rw. 2( VIA ARCHITECT: eSO ��a, rQc FIELD 0 CONTRACT FOR: frreA. ©d,v4,1,e74/ t2Q .‘P,...0 ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract lncuments-that afl_amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. r icates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 2531 ETZ payment shown herein is now que. 2.Net change by Change Orders $ i bi 2-7 C.°" ••NTRACTOR: "A - J ('-'` - 3.CONTRACT SUM TO DATE(Line 1 ±2) $ Z(2,-t, 1 S-7 4:'' By: _ Date: t I'r 1 Jt o 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 'Z(,,`l i l S-7. `" State of: 'P... 5.RETAINAGE: County of: c-,..-- a. %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ me this :S' ay/ f 1.±-•-+ �L Not Public• ;':*e'y b. %of Stored Material �' ;��:!' Deborah Dunville My Commission expires: r •."•+r r. Resident Of(Column F on 0703) $ Y P if,... tie At_•4 , i w.,o�: moon county Total Retainage(Lines 5a+Sb or Total in Column I of 0703). $ ' 3, 2o7. CERTIFICATE FOR PAYME; ..-4,;,;;;;,- e My commission Expires: go a-S In accordance with the Contract Docum:•••:; ,.....:.:, ---2'"e r w a$s and the dab's comprising 6.TOTAL EARNED LESS RETAINAGE $ -Z561 G`� this application,the Construction Manager and •Architect certify to the Owner a. •-1-.best of their (Line 4 Less Line 5 Total) or knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 2y2/ accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) G CERTIFIED. 8.CURRENT PAYMENT DUE $ a, O& , `�� AMOUNT CERTIFIED $ 6 0%1 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs 'om 1 e amount applied.Initial all figures on this !S Application and on 4. Continuation Sh et th,t are anged to conform with the amount certified.) (Line 3 less Line 6) $ /4 27 CONS ' CTION , JAG % ( n By: 11� ,..., �.�. ' Date: 2-? ADDITIONS DEDUCTIONS ARCH "r CHANGE ORDER SUMMARY - Total changes approved in previous months by Owner $ $ By: (/ .J1/lih Date: ZjZ:r lk Total approved this Month $ $ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable bnly to the Contractor TOTALS $ $ 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/CMaN—1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AIAe Document Is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA® 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 taw. ,, 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. CONTINUATION SHEET Date 11/16/2010 APPLICATION AND CERTIFICATE FOR PAYMENT,containing APPLICATION NUMBER: Eleven Contractor's signed Certification is attached. APPLICATION DATE: 11/15/2010 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 11/30/2010 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO. 19/22 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G/C) TO FINISH APPLICATION STORED AND STORED (C-G) (D•E) (NOT IN TO DATE a D OR E) (D+E(F) 0100 Base Contract 0101 Performance&Payment Bond $ 3,870.00 $ 3,870.00 $ 3.870 00 100% $ - 0102 Detailing&Engineering $ 16,695 00 $ 16,695.00 $ 16,695 00 100% $ - 0103 Material MT la rail $ 15,962 00 5 15,962.00 $ 15,962 00 100% $ - 0104 Fabrication MT 15 $ 68,191 00 $ 68,191.00 $ 68,191.00 100% $ - 0105 Installation $ 15,600.00 $ 15,600.00 S 15,600.00 100% $ 0106 Matenal MT lb $ 9,271.00 $ 9,271.00 $ 9,271.00 100% $ - 0107 Fabrication MT lb $ 28,202.00 $ 28,202 00 $ 28,202.00 100% S 0108 Installation $ 8,700,00 $ 8,70000 $ 8,700.00 100% $ 0109 Material MT lc $ 9,528,00 S 9,528 00 S 9,528.00 100% S - 0110 Fabnation MT1c $ 29,952 00 S 29,952 00 $ 29,952.00 100% $ - Installation $ 7,99000 5 7,79000 $ 7,990.00 100% 5 Material 1-line $ 3,724.00 $ 3,724 00 $ 3,724.00 , 100% $ - Fabrication $ 5,916.00 $ 1,183.00 $ 4,733.00 $ 5,916.00 100% $ - Installation $ 2,183.00 $ 2,183.00 $ 2,183.00 100% $ - Powder Coat MT 1A $ 11,091.00 $ 11,091.00 $ 11,091.00 100% $ - Powder Coat MT 18 $ 3,482.00 $ 3,482.00 $ 3,482.00 100% Powder Coat MT 1C $ 7,352.00 $ 7,352.00 $ 7,352.00 100% $ - PowderCoatSingleline $ 1,173.00 $ 1,173.00 $ 1,173.00 100% Change Order#1 $ 8,460 00 $ 8,460.00 $ 8,460.00 100% $ - Cash Allowance Authorization $5,000 $ 5,000.00 $ 5,000.00 100% $ - Change Order#3 $1,815 5 1,815.00 5 1,815.00 100% $ - TOTAL $ 264,157.00 $ 255,868.00 $ 8,089.00 $ - $ 264,157.00 0% $ - $13,207.00 AFFIDAVIT AND WAIVER OF LIEN • Final AV Partial Payment to follow STATE INDIANA, COUNTY OF 3ha.i, -� . SS: t -: - being duly sworn states that he/she is the of /6!,J .B . —;� A,0-a-a-e_ ,a , : ' . � -(title) � (supplier or subcontractor) having contracted with �"-+-(--i �` �u,f_k ' to furnish certain material '; (Contractor) - and/or labor as follows: ti ;'.-,--t L4-t(v[a,yu kM-!� .Z ti .C, �.j, ,�, &..L,..19 .312-'e, /� (description) for the prof kno as (6.4,144 e-4' 0A4,-t_zo-, C-0( 2 j / _ and dwned by - �. :"' located at ('��� � � � Bn y �� architect (rS( < -.< . and does hereby further state on behalf . of the aforementioned subcontractor/supplier. PARTIAL WAIVER that the balance due from contractor is the sum of -t9.�,Q-4 c, -tL. �-- ..,�-<«Q 44--: .� 3 dndollars(S 7-0(i I(h. '" ) ( receipt of which is hereby acknowledged; or ( )the payment of which has been promised as the sole consideration for this affidavit and partial Waiver of Lien,which is given to and for said amount, effective upon receipt for such payment; FINAL WAIVER that the final balance due from the contractor is the sum of . dollars($ ) ( )receipt of which is hereby acknowledged: or ( )the payment of which has been promised as the sole consideration for this affidavit and partial Waiver of Lien which shall become effective upon receipt for such payment. THEREFORE,the undersigned waives and releases unto the owner of said premises,any and All lien of claim whatsoever on the above described property improvements thereon on account • of labor and materials, or both, furnished by the undersigned thereto, and further certifies that no other party has any claim or right to a lien on .. •tint of any work performed or.material furnished to the undersigned fo ;.• payment, /•= within the scope of this affidavit and waiver. / . p„,, .,a_i- Au.g.ti A,,,e6.-„-,,, ,,, ,(name of claimant) ' (authorizelt"representativE) • (title) Witness my hand an• otarial ai,this ' S day of/flow_ - , 1920/0.My co •. -'•n expires: 'V�/c . . (si -.y,. .f no : f ' Residing in _ 4.?, ' County Printed s1.!%.■ l�_ �, "'T" o,„ Deborah Dunviile S 4'•!'?A��i Resident 01 �y Z ites EHzlei Marion County i '.Y"�� 5 My Commission Expires: • , 0#` 4/3/2015 • . •