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HomeMy WebLinkAboutSANTAROSSA MOSAIC & TILE CO INC - 1203 - 300,761.68 - 9/16/2010 CARMEL REDEVELOPMENT COMMISSION Santarossa Mosaic & Tile Co., Check: 1203 2707 Roosevelt Avenue Date: 9/16/2010 Indianapolis, In 46218 Vendor: SANTARO1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 8 57 102,664.25 102,664.25 10,266.42 0.00 92,397.83 Application 8 9 57 225,729.50 225,729.50 17,365.65 0.00 208,363 85 Application 9 328,393.75 328,393.75 27,632.07 0.00 300,761.68 X-41 52LTD CompiiierEase Forms t)ivisian (877)577-5791.;EN5067'00 el. =®=AIA Document G702iCMarM - 1992 2a 57 Application and Certificate,for Payment Construction Manager-Adviser Edition TO OWNERMillet ke e'i et n 'u-Ltn inrisI&PROJECT:nael pre APPLICATION NO:q Distribution to: /fin Olne. (1�I,V,,IIC gigue H PERIOD TO: 000 OWNER ❑ l Hl� e)) k!tUnAµ41AZ CONSTRUCTION MANAGER ❑ FROM CONTRACTOR• j�tlQpr ry VIA CONSTRUCTION MANAGER: CONTRACTDATE:Oa/01069 ARCHITECT ❑ 1U µ Vet+ U PROJECT NOS: Kip( / / CONTRACTOR ❑ 1i1�pi5'' T� �6'2" VIA ARCHITECT: FIELD ❑ CONTRACT FORO1fl$tti Wu -Mc ❑ 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.AIA Document 6703,is attached. Contract Documents. that all amounts have been paid by the Contractor for Rork for which previous Certificates for Payment were issued and payments received from the Owner. and that current 1.ORIGINAL CONTRACT SUM $ 'I. 4 .I1 payment shown erein is now dnue 2. Net change by Change Orders $ I .I 1 CONTRA OR:41I age I I'IO t g 111C nq`o. tie. y�-� q 3.CONTRACT SUM TO DATE(Line 1 ±2) S :r I ' I I I By: j Date: V I ILDI ID 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ amp State ,r]/Iona 5.RETAINAGE: County of:Maea a. %of Completed Work ��7 e Subscribed• 1 Iwo n to b'fo e (Column D+E on G703) $ +2i 322.50 me this r ' ly ' . . Y a re b. _%of Stored Material Notary Puhl I 1' ' ' (Column F on G703) S My Commis. n4spires:) 1,5 Total Retainage(Lines 5a+5h or Total in Column 1 of 6703).. S 4Z,322.50 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $4 49 q-6 716 In accordance with the Contract Documents. based on on-site observations and the data comprising i this application,the Constniction 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 224 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ ,to I '66 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) n/y� �2��2 p��G, CERTIFIED- 8.CURRENT PAYMENT DUE S L.1/U1 JU .g6 AMOUNT CERTIFIED $ 2 b 3l 3 in 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differ '_ am the amount applied. Initial all figures on this A Application and on the Cantiruratio, She that are changed to co fonu with the(1,11011111 certified.) (Line 3 less Line 6) $ 41 414-57 CONST- CTION Ls. / By: �t.'Ait %—last. r Date: Q7/12-7//40 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHIT v , Total changes approved in previous months by Owner $ S S-441 0 Total approved this Month $ $ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ $ named herein. Issuance. payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order S the Owner or Contractor under this Contract. — Director s utedevelopme� CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not t obscured. AIA Document G7021CMa*"-1992.Copyright C 1992 by The American Institute of Architects.AU rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and Internationa Treaties. Unauthorized reproduction or distribution of this Ale Document,or any portion of it,may result in severe clvIl 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 Institutep.rcpitectf Ipgal cou05p1„Oopyright @aia.or . /�j L-..! std? 112010 • 09201•CONTINUATION SHEET AMA DOCUMENT 6703 (Instructions on reverse side) PAGE 2 OF aPAG ES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT. APPLICA'T'ION NO.: 9 containing Contractor's signed Certification, is attached. APPLICATION DATE: 7/15/2010 In tabulations below, amounts are stared to the nearest dollar. PERIOD TO: 7/23/2010 Use Column I on Contracts where variable retainagc for line items may apply. ARCHITECT'S PROJECT NO.: A B C D E F • G H I WORK COMPLETED MATERIALS TOTAL SCH F,IJIJL COMPLETED BALANCE ITEM SCHEDULED PRESENTLY RE1'.AI\AGE NO. DESCRIPTION OF 'WORK FROM PREVIOUS STORED AND STORED �' TO (IF VARIABLE VALUE APPLICATION THIS PERIOD C + C) FINISH ( RATE)VARIABLE) (D + E) (NOT IN TO DATE D OR E) (D+E+F) (C — G) 01.000 STONE FLOORING 01.100 MATERIAL 402,325.00 201,162.50 201,162.50 402.325.00 100 38,515.10 01.200 LABOR 349,950.00 24,031.00 11,702.00 35,733.00 10 314.217.00 1,786.65 01.300 01.400 STONE TOPS 0150(; MATERIAL 20,000.00 10,000.00 10,000.00 20,000.00 100 1.000.00 01.60(+ LABOR 28,000.00 11,200.00 2,865.00 14,065.00 50 13,935.00 703.25 01.700 01.80 QUARRY TILE 01.90 MATERIAL 1500.00 1,500.00 02.00 LABOR 1,500.00 1,500.00 02.10 02.20 GENERAL ALLOWANCE 35.000.00 35,000.00 02.300 CAD AS-BUILT ALLOWANCE 5,000.00 5.000.00 03.40( BOND 3,175.00 3,175.01 3,175.00 100 317.50 03.500 03.60( CHANGE ORDER#1 03.700 • 846,450.0C 249,568.50 225,729.50 475,298.00 56 371,152.01 42,322.50 ��0� AIA DOCUMENT G703 • CONTINUATION SHEET FOR G702 • 1992 EDITION • AIA"' • ©19)2 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK \,1'7�� AVENI IF.,NW,WASIIINGTON,D.C.2(0(6-5292•WARNING:Unlicensed photocopying violates U.S.copyright laws and will subject the violator to legal prosecution. 0703-1992 CAUTION:You should use an original AIA document which has this caution printed in red.An original assures that changes will not be obscured as may occur when documents are reproduced. • WAIVER OF LIEN AND AFFIDAVIT ( ) FINAL p� (4) PARTIAL ( ) PAYMENT TO FOLLOW Jain M.36WIFUSS being duly sworn states that (s) he is )21TTPu(lQjI TQ'L6Uece of SANTAROSSA MOSAIC & TILE CO.. INC. having contracted with • t ' t / to furnish certain materials and/or��labor as kollmvs: Virg I ' for a project known as lMSM inc located at ten , frowma and owned byL110 • i a ' I 'ai L hi I. does hereby further state on behalf of the aforementioned sub/contrac or/supplier. PARTIAL WAIVER That the balance due from the contrac or is the sum of e 65 00 T�vIIawiUui 4 11 �5� 1hUP l'iurrlQ�l�rditi DOLLARS ($ an,&&3. 8h) ( ) Receipt of which is hereby acknowledged: or 04 Payment of which has been promised as the sole consideration for this AFFIDAVIT AND WAIVER OF LIEN (PARTIAL) which is given to and for said amount effective upon receipt of such payment. FINAL WAIVER That the final balance due from the contractor is the sum of: DOLLARS (S ) ( ) Receipt of which is hereby acknowledged: or ( ) Payment of which has been promised as the sole consideration for this AFFIDAVIT AND WAIVER OF LIEN (FINAL) which is given to and for said amount effective upon receipt of such payment. THEREFORE: the undersigned waives and releases unto the said owner of said premises any and all lien or claim whatsoever on the above described property and improvements thereon on account of labor and material.or..both, furnished by.the undersigned.thereto, . „. and further certifies that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project, and within the scope of this AFFIDAVIT and WAIVER. SANTAROSSA MOSAIC & TILE CO., INC. BY: AG // .v/,C„a.4 2 TITLE: �e,latil OnSaCk \\ ■SS ny hand and no Mirk this 2/) day of V 20 Q . CI My Commission Expires: �1�15(11 i l �-�� iota 1' Public . / Residing in Marion, County of Indiana to um A. EX C Printed WAIVER OF LIEN AND AFFIDAVIT ( ) FINAL_ (/ PARTIAL ( ) PAYMENT TO FOLLOW rteaLe being duly sworn states that (s) he is of SANTAROSSA MOSAIC & TILE CO., INC. having contracted with 9nter* r to furnish certain materials and/ r labor follows: 611 : _ .I '!., fi for a project known as I !l ' t located at (T1140. 'Nola and owned by TifItSvdrio +1 mISS��. does hereby further state on behalf of the aforementioned sub/contractor/supplier. PARTIAL WAIVER That the balance due from the contractor is the sum of: In�ThULsanD three 14undQeli SI B 'E 9o�lofl DOLLARS ($ `t, 36t-Q0 ) (V) Receipt of which is hereby acknowledged: or ( ) Payment of which has been promised as the sole consideration for this AFFIDAVIT AND WAIVER OF LIEN (PARTIAL) which is given to and for said amount effective upon receipt of such payment. FINAL WAIVER That the final balance due from the contractor is the sum of: DOLLARS ($ O Receipt of which is hereby acknowledged: or ( ) Payment of which has been promised as the sole consideration for this AFFIDAVIT AND WAIVER OF LIEN (FINAL) which is given to and for said amount effective upon receipt of such payment. THEREFORE: the undersigned waives and releases unto the said owner of said premises any and all lien or claim whatsoever on the above described property and improvements thereon on account of labor and material or both, furnished by the undersigned thereto, and further certifies that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project, and w. in the scope of this AFFIDAVIT and WAIVER. • SANTAROSSA MOSAIC & TILE CO.. 14 . TITLE: 1 .b.[). WITNESS my hand and notarial seal this 284h day of dune 2(711) •� My Commission Expires: f'fl151f7 _ _ - N t ry ublic Residing in Marion, County of Indiana 1\oI. IW A. D jri Printed re 4AILV Document G702/CMa'M - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition 4.7 TO OWNER:C UIl) oiel 7litt ogps$C PROJECT:N me APPLICATION NO: $ Distribution to: On (1:6C S t PERIOD TO:o4 IID OWNER ❑ QU me,i1 'fnOt na 440s2-, CONSTRUCTION MANAGER El FROM CONTRACTOR:$ SCVIA CONSTRUCTION MANAGER: CONTRACT DATE:95101I(Jq ARCHITECT ❑ ��IA +� $ PROJECT NOS: 09.2b1 / / CONTRACTOR El VIAARCHITECT: FIELD 4 CONTRACT FORQMIk1 LiI 7'Fkk ❑ 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,AIA Document 0793,is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment we • issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM • - $ 841p,4SO.bb payment shown s now d e. --II--�,,,,, 2.Net change by Change Orders s b. 0 CO R.,i.-�etro .r1 'tea!( �T(. . Th2 3. CONTRACT SUM TO DATE(Line l ±.2) $ Q t 5 "()d Dv: -�„ �� Date: Qln SVC 4.TOTAL COMPLETED&STORED TO DATE(Column G on 6703) ........._S 24gt RD .so State or lmld La 5. RETAINAGE: County of:Maw, a. I() 53 of Completed Work Subscribed:till sworn to before (Colummn.D+Eon 6703) $ 24956? 95 ice this (S 'y of.,��//4,qh/� b. • eh of Stored Material Notary Puhii 1 ,y ,{�J�'�,}�,y/�- (Column F on 0703) $ My Commissi nn xpires: 2 1 ISlur Total Retainage(Lines 5a+5b or Total in Column I of 6703)- S 14lt lCI sGI� S CERTIFICATE FOR PAYMEN���,,,jjj B.TOTAL EARNED LESS RETAINAGE S 224 W 1I (p,7 hi accordance with the Contract Documents, based on on-site observations and the data comprising t 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 $ ,,213 83 accordance with the Contract Documents.and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) /I fin.,r1 CERTIFIED. 92.311 SZ 8. CURRENT PAYMENT DUE $ 92, 7-I r. z -I AMOUNT CERTIFIED - 5 — 8. BALANCE TO FINISH,INCLUDING RETAINAGE "" • (March erpinnreuon if amount certified differs frau amount applied Initial alll egret on the Applicelion and on el e Continuation SI met that l nixed to cmtfnnn with the niacin!!certified) (Line 3 less Line 6) a CONSTR TION MA ER' �n .. .. By: 1 i. •�/:" A.L a s. Dale: C6 Z4 l0 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHIT- Fr I ']oral changes approvedin previous months by Owner $ $ ny: ; Date: O(e )3,6/66 Total approved Lhis Month $ $ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only In the Contractor TOTALS $ $ named herein- Issuance;-payment and acceptance of payment are without prejudice to any rights of NET CHANCES 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 G702JCMaTa-1992.Copyright G 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 AIAe 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 tc reproduce ten(I0)copies of this document when completed-To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal cgypcpj,oopyr1ht7flityprte. PAID 3Cr 1 ((�atlY —z- 09201 CONTINUATION SHEET AIA DOCUMENT G7I)3 Hitstructions on reverse side) PAGE 2 or �rA<; s AIA Document 0702. APPLICATION AND CERTIFICATE FOR PAYMEN T. APPIICATION NO__ 3 canraining Con m tctor3 Signed Ceriifieation, is attached. APPLICATION DATE: 6/16/2010 In tabulations below, amounts are stated re the nearest dollar. PERIOD TO: 6/23/2010 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECL"S PROJECT NO.: A B C D E F C II I WORK COMPLETED MATERIALS TOTAL BALANCE ITEM SCHEDULED PRESENTLY COMPLETED RF,TAI AIII. DESCRIPTION O1 WORK PROM PREVIOUS AND STORED No. VALIIF, APPLICATION THIS PERIOD STORED 10 DATE (L, � c) FINISH (IF vnRlArsl_a) RATE) (D + P.) B OR E) (q+E I T) (C - C) 01.000 STONE FLOORING 1 01.101 MATERIAL 402525.01 100,581.22 100,581?5 201.162.5[ 50 201,162.3( 30,116.2" 01.20 1 LABOR - 349,950.01 24 031,00 24,031.0( 7 325.919.0( 2,403.1 01.300 01.40.1 STONE TOPS 01.501 MATERIAL 20,000.(( 7,917.00 2,053.0E [0,000.04. 50 10,000.0( 1,000.0 01.600 LABOR 23,000.0€ 11,200.0( )1 200.0( 40 16,800.01 1,120.0 01.70 I 01.801? QUARRY TILE 01.90 MATERIAL 1.500.0( 1.500.04 02.00 LABOR 1,500,Of 1,500.0E 02.10' 02.201 GENERAL ALLOWANCE 35,000.0€ 35-000.00 02.301 CAD AS-BUILT ALLOWANCE 5,000.0€ 5,000.00 03.4011 BOND 3,175.0( 3,175.00 3,175.0( 100 317.51 03501 03.601 CHANGE ORDER#1 03.701 • 846.450.0( 146,904.2/ 102,66421 249,568.S1 I 29 596,881 50 24,936.8- AIA DOCUMENT G703 • CONTINUATION 51111E1' FOR N702 • 1992 LIAIICHF' •AIA • ©1992 • li3E AMERICAN 1NSTITGTE OF ARCIIrtECTS, 1735 NP\CW YORK wee, AVENUE,Na.. awal IAGTON,RC.'_IuJoC 521•WARNING:Unlicensed photocopying violates U.S.copyright laws and will subject the violator to legal prosecution. 6709-1992 CAUTION:You should use an original AIA document which has this caution printed in red.An original assures that changes will not be obscured as may occur when documents are reproduced.