HomeMy WebLinkAboutHAGERMAN CONSTRUCTION CORPORATION - 1008 - 160,860.00 - 8/2/2010 t= T
• : =AIA Document G702/CMar" — 1992
Application and Certificate for Payment Construction Manager-Adviser Edition 5?
TO OWNER: CARMEL REDEVELOPMENT COMPR( JECT: Carmel Regional Perforating Art APPLICATION NO: API'4:00016 Distribution to:
21I City Center Drive
Carmel. IN 46032 PERIOD TO: 5/31/2010 OWNER ❑x
CONSTRUCTION MANAGER 0
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 1/30/2008 ARCHITECT ❑h
I•agerman Construction Corp Dave Brewer
P.O. Box 10690 Shiel Sexton PROJECT NOS: 08-2619-11' / CONTRACTOR ❑
Fort Wayne, IN 46853-0690 VIA ARCHITECT: Brandon Bogan INVOICE NO: 9792 FIELD ❑
CSO Architects Inc
CONTRACT FOR: Masonry ❑
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 G703,is attached. Contract Documents, that all amounts have been paid by the Contractor for Work for which previous
6126,0000(1 Certificates for Payment were issued and payments received from the Owner, and that current
. .
1.ORIGINAL CONTRACT SUM $ payment shown herein is now clue.
2.Net change by Change Orders • $ 939,223.15 CONTRACTOR: agerman Co struction Co C
3.CONTRACT SUM TO DATE(Line I ±2) $ 7,065.223.15 By: / T Dat�.xt
4444`7"`7 2rn n
4.TOTAL COMPLETED 8 STORED TO DATE(Column G on G703) $ 6.865283.15 State of: ndlar a Troy Hessler, Contr011lO : •* •(f]`Nt�°•`S
5.RETAINAGE: County of: Allen • "Its ?.
a. 5.15%of Completed Work i ' li -.
! Subscribed and sworn to before ;/1{1
(Column D+E on G703) $ 353,261.16 me this diaNtabof °- ' r%
b. %of Stored Material Notary Pu. lc 4. - '� • l;:L%-,NOT Or tTr
(Column F on G703) $ My Commission expires: 12-16-2015 �..�••
�1-•
Total Retainage(Lines sa+5h or Total in Column I of G703).. S 353,261.16 CERTIFICATE FOR PAYMENT °•?.irki a''
nr,r, a..::.
In accordance with the Contract Documents, based on on-site obeervatiezinnuqueidata comprising
6.TOTAL EARNED LESS RETAINAGE $ 6 512,021,99 this application,the Construction Manager and Architect certify to the Owner-tH9t to the best of their
(Line 4 Less Line 5 Total) knowledge.inlbrmation and belief the Work has progressed as indicated,the quality of the Work is in
7,LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 6.351.161.99 accordance with the Contract Documents.and the Contractor is entitled to payment of the AMOUNT
(Line 6 from prior Certificate) CERTIFIED.
8.CURRENT PAYMENT DUE S 160.860.40 AMOUNT CERTIFIED $ 160.860.00
9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attack explanation if amount certified differs from the amount applied. Initial all figures on this
Application(7 d on the Continuation Sheet that are changed to confnro with the amount certified)
(Line 3 less Line 6) $ 553,201.16 CONSTRUCT! N N R: Dave Brewer--Shiel Sexton •.
By: ( Date: S.ZJ-if t 0
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITEC : r, d Rogan--CSO Architects Inc ,p�
Total changes approved in previous months by Owner $ 939,223.1 By: Doc S'?�'•yv
Total approved this Month $ $ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor
TOTALS $ 939.223.15 named herein. Issuance. payment and acceptance of payment are without prejudice to any rights of
NET CHANGES by Change Order $ 939223.15 the Owner or Contractor under this Contract.
CAUTION:You should sign an original AR Contract Document,on which this text appears in RED.An original assures that changes will not be obscured.
AM Document G7021CMaTV—1992.Copyright m 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 AlA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org.
CONTINUATION SHEET A IA DOCUMENT G703 PAGE I OF PAGES
AIA Document G702. APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: 00016
containing Contractors signed Certification,is attached. APPLICATION DATE:
In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 5/31/2010
•
Use Column Ion Contracts where variable reusinage for line items may apply. ARCHITECT'S PROJECT NO.: 082619A
A B C D E F (.1 H I
WORK COMPLETED MATERIALS TOTAL BALANCE-
PRESENTLY COMPLETED BETA E
ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS % TO IF VARIABLE)
NO STORED AND STORED FINISH
VALUE APPLICATION THIS PERIOD (NOT'IN O DATE (G-C) RATE
(C +)
C
(D rE) _ DORE) (D1E+E)
00000 50.00 $0.00 $0.00 $0.00 $0.00 0 50.00 $0.00
000000
0000010 GENERAL CONDITION
0000020 Bonding 8 Insurance $56,000.00 $56,000.00 $0.00 $0.00 $56,000.00 100.000 $0.00 $0.00
0000030 Submittals $10000.00 $10,000.00 $0.00 $0.00 $10,000.00 ■00.000 $0.00 $0.00
0000040 Project Meetings $10,000.00 $9,500.00 $300.00 $0.00 $9,800.00 98.000 $200.00 $0.00
0000050 Mobilization $28.000.00 528,000.00 $0.00 $0.00 $28,000.00 100.000 $0.00 $0.00
0000060 Demobilization $25.000.00 $000 $0.00 $0.00 $0.00 0 $25,000.00 $0.00
0000070 Contract Close Out $6.000.00 $0.00 $0.00 $0.00 $0.00 0 $6,000.00 $0.00
0000080 Allowance#4-As-builts $5,000.00 $0.00 $0.00 $0.00 $0.00 0 $5.000.00 $0.00
0000100 EXTERIOR MASONRY
0000110 CMU North Labor $30,000.00 $30,000.00 $0.00 $0.00 $30,000.00 100.000 $0.00 $0.00
0000120 CMU East Labor $25,000.00 • $25,000.00 $0.00 $0.00 $25,000.00 100.000 $0.00 $0.00
0000130 CMU South Labor $37,000.00 $35.150.00 $1,850.00 $0.00 $37.000.00 100.000 $0.00 $0.00
0000140 CMU West Labor 525,000.00 $23,750.00 $1,250.00 $0.00 $25,000.00 100.000 $0.00 $0.00
0000150 CMU Drum Labor $39,000.00 $39,00000 $0.00 $0.00 $39,000.00 100.000 $0.00 $0.00
0000160 CMU North Materials $9,000.00 $9,000.00 $0.00 $0.00 $9,000.00 100.000 $0.00 $0.00
0000170 CMU East Materials $7,000.00 $7,000.00 $0.00 $0.00 $7,000.00 100.000 $0.00 $0.00
0000180 CMU South Materials . 510 000.00 $9.500.00 $500.00 $0.00 $10,000.00 100.000 $0.00 $0.00
0000190 Ct40 West Materials $7,000.00 56,650.00 $350.00 $0.00 $7,000.00 100.000 $0.00 $0.00
0000200 CMU Drum Materials $12,000.00 $12,000.00 $0.00 $0.00 $12,000.00 100.000 $0.00 $0.00
0000210 Vapor Barrier Labor $162,000.00 $162,000.00 $0.00 $0.00 $162000.00 100.000 $0.00 $0.00
0000220 Vapor Barrier Materials $98,000.00 $98,000.00 $0.00 $0.00 $98,000.00 100.000 $0.00 $0.00
0000240 EXTERIOR VENEER
0000250 Granite Labor $205,000.00 $194,750.00 $8,200.00 $0.00 5202.950.00 99.000 $2,050.00 $0.00
0000260 Granite Materials $504,000.00 $504,000.00 50.00 $0.00 5504,000.00 100.000 $0.00 $0.00
0000270 Limestone North Labor $878,000.00 5876,000.00 $0.00 $0.00 $878,000.00 100.000 $0.00 50.00
0000280 Limestone North Materials $126,000.00 $126,000.00 $0.00 $0.00 $126,000.00 100.000 $0.00 $0.00
0000290 Limestone East Labor $734,000.00 $734,000.00 $0.00 $0.00 $734,000.00 100.000 $0.00 $000
0000300 Limestone East Materials $107,000.00 $107,000.00 $0.00 $0.00 $107,000.00 100.000 $0.00 $0.00
0000310 Limestone South Labor $890,000.00 $845,500.00 $17,800.00 $0.00 $863,300.00 97.000 $26,700.00 $0.00
0000320 Limestone South Materials $132,000.00 $125,400.00 $2,640.00 $0.00 $126,040.00 97.000 $3,960.00 $0.00
AlA DOCUMENT G703• APPLICATION.AND CERTIFICATE FOR PAVMRNT • 1992 EDITION • ALA®• 01992 • THEAME..RICAN INSTITUTE OF ARCHITECTS.1735 NEW YORK G703-1992
AVENUE.N.W.,WASHINGTON,D.C. 204}164292 • WARNING: Unlicensed photocopying violates U.S.copyright laws and will subject the violator to legal prosecution.
"TMs MUmenl has been lep,v.LeMe4[HMkeM1Y Vbl the Pe"etimal raeA,rener lneALle of Melvin'.vev tko'n-MCI N Vr+Torwd Ygyne.Inc.FeYWVAa,of I.exyrreltwert pnyeeltYefcmwmelrm k nit pvmtbc.Cwn act The 0.,nun lobule Cl NtlMa6[
a von.Y V«n,reM.arenn ul tl',.Ocunn•tl n'0 Mcnw cl.WS:
CONTINUATION SHEET ALA DOCUMENT G703 PAGE OE PAGES
AIA Document 0702.APPLICATION AND CERTIFICATE FOR PAYMENT. APPLICATION NO.: 00016
containing Contractor's signed Certification,is attached. APPLICATION DATE:
In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 5/31/2010
•
Use Column Ion Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO.: 082619A
A 13 C I) E F G H l I
' WORK COMPLETED MATERIALS TOTAL BALANCE
RETAINAGE
ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % TO ir VARIABLE)
NO. VALUE STORED AND STORED FINISH RATE
APPLICATION THIS PERIOD (NOT IN TO DATE (C,C) C-G
)
(D+E) D OR E) (D:E÷P)
0000330 Limestone West Labor . $734,000.00 $6697,300.00 $14,680.00 $0.00 $711,980.00 97.000 $22,020.00 $0.00
0000340 Limestone West Materials $107,000.00 $96,300.00 $7,490.00 . $0.00 5103,790.00 97.000 $3,210.00 $0.00
0000350 Cast Stone Drum Labor $249 000.00 $249,000.00 $0.00 $0.00 5249,000.00 100.000 $0.00 $0.00
0000360 Cast Stone Drum Materials 5330,000.00 $330,000.00 50.00 $0.00 $330,000.00 100.000 $0.00 $0.00
0000370 Cleaning 8 Caulking Labor $288,000.00 $172,800.00 $57,600.00 $0.00 $230,400.00 80.000 557,600.00 $0.00
0000380 Cleaning 8 Caulking Materials $241 000.00 $144,600.00 $48,200.00 $0.00 $192,800.00 80.000 543,200.00 $0.00
0000400 CHANGE ORDERS
0000410 CO 41-Limestone Field Stone
0000420 Limestone Field Labor $480,000.00 $480,000.00 $0.00 $0.00 5480,000.00 100.000 $0.00 $0.00
0000430 Limestone Field Material $250,000.00 $250,000.00 $0.00 $0.00 5250,000.00 100.000 $0.00 $0.00
0000450 CO#2-Drum Veneer
0000460 Drum Veneer Labor $110,000.00 5110.000.00 $0.00 $0.00 $110,000.00 100.000 $0.00 $0.00
0000470 Drum Veneer Materials $90.000.00 590,000,00 $0.00 50.00 590,000.00 100.000 $0.00 $0.00
0000490 CO 43-PAC 0251 -Granite Jointing .
0000500 Granite Labor $49214 $492.14 $0.00 $0.00 $492.14 100.000 $0.00 $0.00
0000510 Granite Material $7,150.00 $7,150.00 $0.00 $0.00 $7,150.00 100.000 $0.00 $0.00
0000530 CO 44-Granite Door Jamb
0000540 Granite Labor $41.01 $41.01 $0.00 $0.00 541.01 100.000 $0.00 $0.00
0000550 Granite Material $1,540.00 $1,540.00 $0.00 $0.00 51,540.00 100.000 50.00 $0.00
$7,065,223.15 $6,704,423.15 $160,860.00 $0.00 $6,865,283.15 97.17% $199,940.00 • $0.00
AIA DOCUMENT 0703•APPLICATION AND CERTIFICATE FOR PAYMENT • 1992 EDITION • AIAD• 01992 •THF,AMERICAN INSTITUTE OF ARCHITECTS,1135 NEW YORK G703-1992
AVENUE,F.W.,WASHINGTON,U.C. 20006-5292 • WARNING. Unlicensed photocopying violates U.S.copyright laws and will subject the violator to legal prosecution.
"It.dnmordnas See,'epoeucd e4NorvoIY•n'IM rerMUbn of ois emit than Ie:AWb 52 2,elvlape tree'Leaw.woos 5 P,n e,.$yilnmf,Ine nete000Ciee of I99 Mt5nWa MITwr PMMI',ptCnbnatun la mI OwMtle:.Consci us Amerces Inw,',o14tlhieps
n vnM Ue moment vets el Yµott`_mm end keme deras
WAIVER OF LIEN •
The undersigned is the duly authorized officer of Hagerman rnnstnirrinn Cnrpnratinn ,the general contractor, .
(Name of Company)
subcontractor,'materialman or other person furnishing the services, labor, material or equipment indicated below in. the
construction of improvements upon real estate located in Hamilton County, State of •Indiana , commonly ..
known ash Regional E rfornirgArts which real estate is owned.by city nf Cannel Rn ,elc{rwr ("Owner ).
Y Ctrarissim
IN CONSIDERATION of the sum of Six millirn five tnrdrei twelve thasen3 twenty one and 93/100
DOLLARS($6,512,021.99 ' receipt of which is hereby acknowledged, and in order to procure one or more payments
for services, labor, material or equipment provided in such construction, the Company does hereby waive, release and quit •
claim in favor of the Owner of the real estate and the lender or lenders providing funds with which payment of construction
costs is or is to be made,and their assigns,all liens or claim or right to liens upon the land or improvements above described,
which the Company may now have for services,labor,material or equipmentfumished in respect of such landorimprovements
to and including the date hereof. The undersigned warrants that the Company has not and will not assign any claim for payment
nor any right to perfect a lien against the real estate, and that he has the right to execute this waiver and release of liens on
behalf of himself(herself) and the Company.
•
The undersigned further warrants and represents that the Company has the right to transfer and does hereby transfer title to
the services, labor,material or equipment to the Owners or lenders named above in consideration of the payment received
hereunder. The undersigned further states that the consideration received hereunder is the sole consideration received by
the Company for said services,Iabor,material or equipment furnished to date,and that the Company has neither received nor
made any security interest,title retention interest or lien rights in the said services,labor,material or equipment other than that
released and transferred hereby.
The material, labor,services or equipment furnished ire more particularly described ii the affidavit for payment submitted of
even date herewith. The undersigned further warrants and represents that the Company has complied with all prevailing wage
requirements under applicable law or as may be set forth in the contract documents.
WITNESS the execution hereof thi s 20th day of
May 2010
oy Heis` , e-and Title)
Controller
•
Hagerman Construction Corporation
(Name of Company)
State of Indiana , County of Allen • , SS: Before me, the
undersigned, a Notary Public in and for said County and State, personally appeared Troy Heisler
the controller . of Hagerman rnnarnirrinn rnrpnratinn , who acknowledged
(Title) (Name of Company)
the execution of the foregoing Waiver of Lien on behalf of such Company and that the same is the free act and deed of such
Company and the free act and deed of said officer.
WITNESS my hand and notarial seal this 20th day of May 2010_.
ot• .. s .
,
. My Commission Expires: ;GQ�MISSIpy•, d •..
eA ober/g •: otary Public
12/16/15
• • mac, 1l! aO��•
• .Ai
�a NOTAq} f . r•My County of Residence: o�,. F�
. _, David Thnmaa
y4:74..... \tip`; (Printed Name of Notary Public)
Allen ';STATED`
Prescribed by State Board of Accounls City Form No-201 IRev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
IILL
Payee
Kaye Zvi CO 97 576-."<")/ J/7 C ;70 Purchase Order No.
/0698 Terms
�Or71- -c; Ail 176 55 3-06 96 Date Due
Invoice Invoice Description Amount
Date 13 Nu mber �/ (or note attached invoice(s) or bill(s)) C
5 ///0 /6 ///i/J/e4/ /G /o -7 /‘4 S o..ci 1
Total lea g6 - 0
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5-11-10-1.6.
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
roC-Gr,_
IN SUM OF $
/034 /& y
lo ./ �l/ 7 7-J A/O?S3 - OG9c
$ /p Fre& _a0
ON ACCOUNT OF APPROPRIATION FOR
902A/1/618G7
Board Members
PDU or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.a I hereby certify that the attached invoice(s), or
got /G S'<1-" '.' /60,,W4r bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
e -/ 20/0
Signature
nirector of Re‘clovelopmth.t
Cost distribution ledger classification if TI e
claim paid motor vehicle highway fund