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HomeMy WebLinkAboutCIRCLE B CONSTRUCTION SYSTEMS - 1249 - 55,584.00 - 10/21/2010 1IW• Jk.DQcumefltb7o2fcMaTL" - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition g 70 TO OWNER: - _ PROJECT: - APPLICATION NO o CARMEL REDEVELOPMENT 'COMMISSION GAP.MF,L PERFORMING ARTS CENTER ? Distribution ONE CIVIC SQUARE PERIODTO: . - )_;57l7TC"�.. to. CARMEL, -INS• 46032 .. OWNER ❑ " CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION.MANAGER: OSACI:E Il_CONSTRUCTION SYSTEMS SHIEL SEXTON COMPANY CONTRACT DATE: ARCHITECT ❑ PROJECT / / CONTRACTOR ❑ 5636 S. MERIDIAN ST. INDIANAPOLIS, IN 46217 VIA ARCHITECT: i/2695/3090. FIELD ❑ CONTRACT FOR: PLASTER CSO ARCHITECHS ❑ 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 0703,is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous I ORIGINAL CONTRACT SUM Certificates for Paym t ere issued and payments received from the Owner, and that current $ 737,$j 0,00 Paymentsh. ;ere s w due ;, 2. Net change by Change Orders + S__ CONT•• •- ' dpunAAR). 3.CONTRACT SUM TO DATE(Line + 7) S 137,860.00 By r 2. B INSTRUCTION SY� ARr rbjrr 4.TOTAL COMPLETED B STORED TO DATE Column G 9 State / i N Ds. ;r"": reates—,,c-, C. _o- ( on .........5 80,9_0.00 oC pit.; A` y a 5 RETAINAGE i.G1 - - y�. a ,o of Completed Work .. County .tARIO - �t 'lJ , - •mac (Cotunm D+Eon G703 Subse,be3�d swo t o ' A. NDER S 8.092.00 moils UI�E a�ot Z�[/ / '1: _ b o _ (/fix/ 4c or Stored Material My Co Public. ( z // xi _'-1., A i �11RSIT TE OF INDIANA e �t`i• Fes. (Cotunm F on G7U3) S -. My Cy ums c. +4 es: lactsr- Total Retainage(Lines 5a+5h or Total in Column I of 0703)_ S_8,09� On CERTIFICATE FOR PAYMENT •' " ` 6.TOTAL EARNED LESS RETAINAGE $ 72,828•00 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Lice SToral) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT. : 17,244.00 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in $ accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. - - Q 8.CURRENT PAYMENT DUE IS SS.S-84.,00 I AMOUNT CERTIFIED $ SS,St-1 (Attach explanation if amount certified differs fr te.aniotin'tapplied.Initial all figures on this 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Line 3 less Line 6) 't ;7-.1-1 Application at on Continuation SSI,nth•l�lDl ./tan ed to conform with the amount certified) $ 65,032.00 CONS • CTIO / ® f CHANGE ORDER SO,\9MAR1 ADDITIONS DEDUCTIONS By 'b , ��� A" Date: D7/3jo tQ $ ARCH '����� / c jjT 1 Total changes apprpvcil in previous months by Owner $ _ .— Total approved this Nionth �: $ $ — —` Date e�301 t This CeruItcate is,no!.negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ S named herein. Issuance pavnlent and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order I $ 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,CMar°-1992.Copyright ©1992 by The American institute of Archtects.All rights reserved.WARNING:This AIA'Document is prolected 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 he prosecuted to the maximum extent possible under the law. Purchase's are oermined to reproduce:en(10)copies ci this denement when completed.To red copyright violations of AIA Contract Documents,email The American Institute of Architects'legal counsel,copydgh@aia.org. a� ti 41W4 . -, - Document G703" - 1992 • Continuation Sheet AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: containing Contractor's signed certification is attached. APPLICATION DATE: 2 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 07/15/2010 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 07/15/2010 A B C D I E F __ G I H I WORK COMPLETED • MATERIALS TOTAL BALANCE ITEM DESCRIPTION OF WORK SCHEDULED PRESENTLY COMPLETED y., ,t,0 RETAINAGE FROM PREVIOUS (G+C) FINISH • ,NO, STORED AND STORED (IF 4:ARIABLIi VALUE APPLICATION THIS PERIOD (NOT IN TO DATE RATE) (D+E) DORE) (D+E+F) (C-G) • 100 MATERIAL 15.160.00 7,580.00 7.580.00 15,160.00 100.00 1,516.00 101 CARPENTERLAI3OR 57.900.00 11,580.00 34,740.00 46,320.00 80.00 11,580.00 4,632.00 102 PLASTERER LABOR. 64,800.00 19,440.00 19,440.00 30.00 45,360.00 1,944.00 • • • • JO.0.401-ALS • 137,360-00-----1-9-1.60-09 E1'• 000 1 .00 --80:920,00 56:940c00 8,092.00 1 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 G703"'-1992.Copyright O 1963,1965,1966 1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA"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 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`raia.org.