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HomeMy WebLinkAboutMACDOUGAL PIERCE- 162- 1/5/2011 MacDougal Pierce Check: 162 12720 Ford Drive Date: 1/5/2011 Fishers, IN 46038 Vendor: MCDOUG1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 2-4 76,991.40 76,991.40 0.00 0.00 76,991.40 App 4 on Black Box Theater 76,991.40 76,991.40 0.00 0.00 76,991.40 162 1/5/2011 **********76,991.40 THE SUM OF SEVENTY SIX THOUSAND NINE HUNDRED NINETY ONE DOLLARS AND 40 CENTS * MacDougal Pierce 12720 Ford Drive Fishers, IN 46038 MacDougal Pierce Check: 162 12720 Ford Drive Date: 1/5/2011 Fishers, IN 46038 Vendor: MCDOUG1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 2-4 76,991.40 76,991.40 0.00 0.00 76,991.40 App 4 on Black Box Theater 76,991.40 76,991.40 0.00 0.00 76,991.40 AI'Vl_IUA I IUN AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF ONE PAGES TOO OWNER: PROJECT: APPLICATION NO: Distribution to: City of Carmel BLACK BOX THEATR FOUR { OWNER PERIOD TO: [ ARCHITECT FROM CONTRACTOF VIA OWNERS ' T t U 11/30/10 CONTRACTOR MacDougall Pierce Construction, Inc. Nov % --- L PROJECT NOS: I CONTRACT FOR: \ _— CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been completed Continuation Sheet,AIA Document G703,is attached. in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner,and that current payment shown herein is now due. 1. ORIGINAL CONTRACT SU. 448,955.00 - \ Ni 2. Net change by Change Orders 5,013.39 CONTRA '4 1 : CDou • 1 Pierde Construction,Inc. 3. CONTRACT SUM TO DATE(Line 1±2). 453,968.39 / ' �' 4. TOTAL COMPLETED&STORED TO DA 378,408.39 , * � e y ,allay=lam Date: - 11/23/10 5. RETAINAGE: a. 10% %of Completed Work $ 37,840.84 State of Indi. . Coun o . -.miltb (Column D+E on G703) Subscribe. and sworn .k.tifi 23rd da, of No -af,ber 2014 b. %of Stored Materia 0.00 NOTARY •UBLIC: ' 41.q.).(.2 ' r - , A\ , (Column F on G703) My Commiss .- - :''es 3/20/1, l Total Retainage(Lines 5a+5b or Total in Column I ofG70: 37,840.84 OWNER'S REP. CERTIFICATE F PAYMENT 6. TOTAL EARNED LESS REl 340,567.55 In accordance with the Contract Documents,based on on-site observations and the data (Line 4 Less Line 5 Total) comprising the application,the Owners Rep certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR 263,576.15 Owner's rep knowledge,information and belief the Work has progressed as indicated,the quality PAYMENT(Line 6 from prior Certificate of the Work is in accordance with the Contract Documents,and the Contractor is entitled to 8. CURRENT PAYMENT DUE '76091:40. payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RET 113,400.84 J ,"A (Line 3 less Line 6) AMOUNT CERTIFIED $7 6 °17/ RDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount certified differes from the amount applied.Initial all figures on this Total changes approved Application and on the Continuation Sheet that are changed to conform to the amount certified.) in previous months by Owner $5,013.39 Owners Rep: !'? Total approved this Month $0.00 By�- '"�/n�O`�-j� Date: /273/f / TOTALS $5,013.39 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein.issuance,payment and acceptance of payment are without NET CHANGES by Change C 5,013.39 prejudice to any rights of the Owner or Contractor under this Contract. �v AIA DOCUMENT G702•APPLICATION AND CERTIFICATION FOR PAYMENT•1992 EDITION•AIA •©1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006-5292 PARTIAL LIEN WAIVER AFFIDAVIT • WHEREAS, MacDougall Pierce Construction, Inc. ("Contractor")has been heretofore employed by Black Box Theatre(Company")to furnish certain material, supplies, equipment or labor for or in connection with improvements owned by, Same ("OWNER" and located on Carmel, IN (Hereinafter collectively referred to as the Premises"); and WHEREAS, the undersigned is duly authorized to execute this Partial Waiver of Lien for and on behalf of the Contractor: NOW, THEREFORE,the Contractor, for and in consideration of the receipt of Seventy six thousand nine hundred ninety one 40/100 ($ 76,991.40 ) Hereby waives, and releases the Owner of the Premises and the Company from any and all liens, rights of lien or claims of whatsoever kind or character on or against the Premises or the improvements located thereon on account of any and all labor, supplies, equipment or material furnished for, in connection with or incorporated in the Premises by the Contractor on or before the date hereof. This Partial Waiver of Lien is given in order to induce the Company to pay the amount indicated above, and upon receipt of such amount by the Contractor,this release may be recorded,become valid, enforceable and of full effect. MacDoug. - ' ce_ r, sty • Signature of Authorized Representative Brent Houston Printed Name TITLE Project Manager DATE: 11/30/10 STATE OF INDIANA COUNTY OF Hamilton Before me,a Notary Public in and for said county and State,personally appeared Brent Houston Who acknowledged the execution of the foregoing Partial Waiver of Lien, and who,having been sworn, stated that the representations therein contained are true. Witness my hand and No,r-iate'al is •, • f November , 201 0 . My Commission expires 3-20-16 Nottir Public — : Tanya Bi kford un y of Res jam.- Dela are CONTINUATION SHEET A/A DOCUMENT G703 PAGE OF PAGE AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT, containing APPLICATION NO: 4 Contractor's signed certification is attached. BLACK BOX THEATER APPLICATION DATE: 23-Nov-10 In tabulations below,amounts are stated to the n - PERIOD TO: 30-Nov-10 Use Column I on Contracts where variable retainage for line items may apply. CMS PROJECT-NO: 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 (IF VARIABLE APPLICATION ` STORED AND STORED (C-G) RATE) (D+E) (NOT IN TO DATE D OR E) (D+E+F) GENERAL CONDITIONS(M) $3,300.00 $ 1,760.00 $ 770.00 $ 2,530.00 76.67% $ 770.00 $ 253.00 GENERAL CONDITIONS(L) $5,042.00 $ 2,353.00 $ 1,345.00 _$ 3,698.00 73.34% $ 1,344.00 $ 369.80 BOND $3,659.00 $ 3,659.00 $ - $ 3,659.00 100.00% $ - $ 365.90 MISC. METALS(M) $39,060.00 $ 39,060.00 $ - $ 39,060.00 100.00% $ - $ 3,906.00_ MISC. METALS(L) $16,740.00 $ 15,240.00 $ 1,500.00 $ 16,740.00 100.00% $ - $ 1,674.00 ORNAMENTAL RAILING(M) $13,679.00 $ 13,679.00 $ 13,679.00 100.00% $ - $ 1,367.90 ORNAMENTAL RAILING(L) $4,559.00 $ 4,559.00 $ 4,559.00 100.00% $ - $ 455.90 FINISH CARPENTRY(M) $2,309.00 $ 2,309.00 $ 2,309.00 100.00% $ - $ 230.90 FINISH CARPENTRY(L) $1,720.00 $ 1,720.00 $ 1,720.00 100.00% $ - $ 172.00 INSULATION(M) $1,191.00 $ 1,191.00 $ - $ 1,191.00 100.00% $ - $ 119.10 INSULATION(L) $2,779.00 $ 2,779.00 $ - $ 2,779.00 100.00% $ - $ 277.90 FIRESTOP(M) $1,000.00 $ 1,000.00 $ 1,000.00 100.00% $ - $ 100.00 FIRESTOP(L) $1,500.00 $ 1,500.00 $ 1,500.00 100.00% $ - $ 150.00 CAULKING(M) $300.00 $ - $ 300.00 $ - CAULKING(L) $700.00 $ - $ 700.00 $ - DOORS/FRAMES/HDWE(M) $25,547.00 $ 3,832.00 $ 21,715.00 $ 25,547.00 100.00% $ - $ 2,554.70 DOORS/FRAMES/HDWE(L) $5,174.00 $ 1,023.00 $ 1,564.00 $ 2,587.00 50.00% $ 2,587.00 $ 258.70 ACCESS DOORS(M) $500.00 $ 500.00 $ 500.00 100.00% $ - $ 50.00 ACCESS DOORS(L) $250.00 $ 250.00 $ 250.00 100.00% $ - $ 25.00 COILING DOORS(M) $3,175.00 $ 3,175.00 $ 3,175.00 100.00% $ - $ 317.50 COILING DOORS(L) $1,360.00 $ 1,360.00 $ 1,360.00 100.00% $ - $ 136.00 WINDOWS(M) $2,400.00 $ 2,400.00 $ 2,400.00 100.00% $ - $ 240.00 WINDOWS(L) $3,600.00 $ 3,600.00 $ 3,600.00 100.00% $ - $ 360.00 METAL STUDS/DRYWALL(M) $33,084.00 $ 33,084.00 $ - $ 33,084.00 100.00% $ - $ 3,308.40 METAL STUDS/DRYWALL(L) $49,626.00 $ 39,701.00 $ 9,925.00 $ 49,626.00 100.00% $ - $ 4,962.60 ACOUSTICAL CEILINGS(M) $3,476.00 $ 3,476.00 $ 3,476.00 100.00% $ - $ 347.60 ACOUSTICAL CEILINGS(L) $2,844.00 $ 1,422.00 $ 1,422.00 50.00% $ 1,422.00 $ 142.20 WOOD FLOORING(M) $38,593.00 $ - $ 38,593.00 $ - WOOD FLOORING(L) $16,982.00 $ - $ 16,982.00 $ - TENSION WIRE GRID SYSTEM(M) $70,800.00 $ 70,800.00 _ $ - $ 70,800.00 100.00% $ - $ 7,080.00 5FAIA DOCUMENT G703 • CONTINUATION SHEET FOR G702 • 1992 EDITION • AlA• © 1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-529211 05F 4F bG703-1992 CONTINUATION SHEET AIA DOCUMENT G703 PAGE OF PAGE ■ . AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT,containing APPLICATION NO: 4 Contractor's signed certification is attached. BLACK BOX THEATER APPLICATION DATE: 23-Nov-10 In tabulations below,amounts are stated to the n I5ERTOD TO: 0-Nov-10 Use Column I on Contracts where variable retainage for line items may apply. CMS PROJECT NO: - A B C D E F G I H l I - ITEN DESCRIPTION OF WORK SCHEDULED WORK COMPLETED 1 MATERIALS TOTAL % BALANCE -4 RETAINAGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G=C) TO FINISH (IF VARIABLE APPLICATION STORED AND STORED (C-G) _ RATE) (D+E) (NOT IN TO DATE — D OR E) (D+E+F) TENSION WIRE GRID SYSTEM(L) $47,200.00 $ 47,200.00 $ - $ 47,200.00 100.00% $ - $ 4,720.00 _OVERHEAD&PROFIT $46,806.00 $ 26,167.00 $ 7,777.00 $ 33,944.00 72.52% $ 12,862.00 $ 3,394.40 CHANGE ORDER#1 $5,013.39 $ 5,013.39 $ - $ 5,013.39 100.00% $ - $ 501.34 TOTALS $453,968.39 $292,862.39 $ 85,546.00 $ - $378,408.39 83.36% $ 75,560.00 $ 37,840.84 5FAIA DOCUMENT G703 • CONTINUATION SHEET FOR G702 • 1992 EDITION • AIA • © 1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-529211 05F 4F bG703-1992