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HomeMy WebLinkAboutCIRCLE B CONSTRUCTION SYSTEMS - 26,064.00 - 7/31/2010 - NO CHECK WRITTEN BY CRC s TT • = =�1 A Document G702/CMa TM ® 1992 Application and Certificate for Payment Construction Manager-Adviser Edition REVISED JULY 7c1 TO OWNER: PROJECT: APPLICATION NO: .," -t-L.; : - Distribution to: CARMEL REDEVELOPMENT COMMISSION 36gU�112 OMhIISSION CARMEL PERFORMING ARTS CENTER PERIOD TO: i/31/2010 OWNER ❑ ONE CIVIC SQUARE CARMEL, -.IN• 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT ❑ • CIRCLE B CONSTRUCTION SYSTEMS SHIEL SEXTON COMPANY - 5636 S. MERIDIAN ST. PROJECT NOS: ( CONTRACTOR ❑ c INDIANAPOLIS, IN 46217 VIA ARCHITECT: 2695/3090 FIELD ❑ CONTRACT FOR: STUCCO ,09° SCO ARCHITECTS LI 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 Contrac t. belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet AIA Document G703,is attached. Contract Documents, that all amounts have been paid by the Contractor for Work for which previous - - Certificates for Payme t were issued and payments received from the Owner, and that current 1 ORIGPNAL CONTRACT SUM 5 489,340 .00 payment shove ow due. -' 2. Net change by Change Orders $(441,220.00) CONTRA 4 s' i CONSTRUCTION:::SYSTEMS 3. CONTRACT SUM TO DATE (Line I t,2) $ 48, 120.00 By: -jgar Date: 8/31/2010 4.TOTAL COMPLETED!.STORED TO DATE(Column G on G701) .. .. .,..S 48, 120.00 Slate of: II• to ;.,, F 5.RETAINAGE Cour PF: MARION. ' a. 'If of Cornpleied Work Su scribed and sw co h ore CATHY A.!BINDER TE OF (ColimmU+F.onG7U3) $ 4,812.000 lie this a nl' j�f NOTARYROOM&ATEOFINDLWA 31ST / UGU T, 10 �FNSONCOUNTY b. %of Stored Material Notary Public: MY ON I •FEB.1,2017 (Columm F on G703) $ My Cnmmissio x r s. LLL{{{--- Total Retainage(Lines 5a f Sb or Total in Column 1 of G703).. $ 4.812. 00 CERTIFICATE FO PA MENT 6.TOTAL EARNED LESS RETAINAGE $ 43,308 .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(heir (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 $ 17,244.00 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. I 8.CURRENT PAYMENT DUE.... . ... .. ............ S 26,064.00 AMOUNT CERTIFIED -= S 2to 52:1 9.BALANCE TO FINISH,INCLUDING RETAINAGE _ _ (Moen eapinnatton if amount certified differs 'on he,aatount applied. Initial all'figrtres on this Application and o le Con«nunrimt Alert rh 1 me ha_noed to conform with the anmw¢certified.) (Line 3 less Line 6) $ 4,812,00 CON i CTION A "' VS/it � By: 4•t!'_�44%t+4_4 Date: it l 1 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARC ECT: +�� -- Total changes approved=in previous months by Owner S $ By.: Date: 34. Total approved this'Month $ $ This Certifi• e i. "negotia' AMOUNT CERTIFIED is payable only to the Contractor - TOTALS $ $ named he in. Iss ,ncc, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order 3- the Owr r or Confractor 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 G78210Man'—1992.Copyright 01992 by The American Institute at Architects.All rights reserved.WARNING:This AlAe Document is protected by U-5.Copyright Law and International Treaties. 6 Unauthorized reproduction or distribution of this AIA® Document,or any portion edit,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,a-mail The American Institute of Architects'legal counsel,copyright @aia.oeg. F S• TT f AJA Document G703" - 1992 . Continuation Sheet ALA Document 0702,APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: containing Contractor's signed certification is attached_ APPLICATION DATE: 4 In tabulations below,amounts are stated to the nearest dollar_ PERIOD TO: CIS/?112010 Use Column Ion Contracts where variable retainage for line items may apply_ ARCHITECT'S PROJECT NO: 08/31/2010 A B C D I E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE ITEM PRESENTIX COMPLETED RETAINAGE DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS TO NO STORED AND STORF,D CI C (IF vAR1ABLE VALUE APPLICATION THIS PERIOD ( ) FINISH INOT T\' TO DATE _ RATE) (D+E) D OR E) (D+E+F) tC-Cr) 100 MATERIAL 166.64000 7.580.00 159.060.00 166,640 00 100.00 101 CARPENTER T,A13OR 157,900 00 1 1580.00 146,320 00 157,900.00 100.00 102 PLASTE.REI<LABOR 164,800.00 164.800.00 164,800.00 100.00 201 CHANGE ORDER41 -391.350.00 -391350.00 -39€.350.00 100.00 202 CHANGE ORDER 02 -44.870.00 -44.870.00 -44,870-00 100.00 203 CHANGE D1W.I5R 3 -5.000.00 -5.000.00 -5.000.00 100.00 - )/1-TOT-A-1=St: i 'Iu,1u0_ 1n 19,1-10.31)283a4LGO— .00 18,121.00— 0 1.912.00 _ i CAUTION: You should sign an original MA Contract Document,on which this text appears in RED. An original assures that changes wilt not be obscured. AIA Document G703T"–1992.Copyright©1963,1965, 1966 1967,1970,1978, 1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIM Document is protected by U.S.Copyrlght Law and International Treaties.Unauthorized reproduction or distribution of this AIM Document,or any portion al 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 @ala,org-