The URL can be used to link to this page

Home My WebLink AboutBROADY-CAMPBELL - $120,784.86 - 1/31/2011 Application and Certificate for Payment TO OWNER: CARMEL THEATER DEVELOPMPROJECT: VILLAGE ON THE GREEN 7-C APPLICATION NO: 4 Distribution to: CUST 4 CAR4 11711 N. PENN ST. PERIOD TO: 01/31/2011 OWNER SUITE 200 CARMEL IN 46032 CONTRACT FOR: 12012 ARCHITECT FROM CONTRACTOR: BROADY-CAMPBELL,INC. VIA ARCHITECT: CONTRACT DATE: 06/23/2010 CONTRACTOR 2115 Dr.A.J.Brown Ave. PEDCOR DESIGN GROUP PROJECT NOS: FIELD Indianapolis,IN 46202 VILLAGE ON THE GREEN7-C JOB# 210056 OTHER CONTRACTOR'S APPLICATION FOR PAYMENT undersigned s The Contractor certifies that to the best of the Contractor's knowlcdnc. informruion Application is made for payment, as shown below, in connection with the Contract and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents that all amounts have been paid by the Contractu for Work for Continuation Sheet, is attached. 898,000.00 which previous Certificates for Payment were issued and payments received fiom the Owner, and 1. ORIGINAL CONTRACT SUM $ that current payment shown herein is now due. 2. Net change by Change Orders -19,805 00 9 Y 9 $ CONTRACTOR: Broady-Cam bell, Inc. 878,195.00 3. CONTRACT SUM TO DATE(Line 1 ±2) $ By: or. Date. 11-31-20_t 1 4.TOTAL COMPLETED & STORED TO DATE(Column G on 603LS1).... $ 442,935 50 State of Indiana 5. RETAINAGE: County of Marion 10.00 0 a. /u of Completed Work 44,293.55 Subscribed and sworn to before (Column D+E on 603LS1) $ me this 31st day of January 2011 b 10.00 u/c of Stored Material (Column F on 603LS1) $ 0.00 Notary Public: �� Total Retainage(Lines 5a+5b or Total in Column I of 603LS1) ... $ 44,293.55 My Commission expires: 5-5-2016 6.TOTAL EARNED LESS RETAINAGE $ 398,641.95 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 Less Line 5 Total) In accordance with the Contract Documents, based on on-site observations and the data comprising 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 277,857.09 this application, the Architect certifies to the Owner that to the best of the Architect is know ge led . $ information and belief the Work has progressed as indicated, the quality of the Work is in (Line 6 from prior Certificate) accordance with the Contract Documents, and the Contractor is crniticd to pas tip nt of the 8. CURRENT PAYMENT DUE $ 120,784.86 I AMOUNT CERTIFIED. S. BALANCE TO FINISH, INCLUDING RETAINAGE AMOUNT CERTIFIED s 12j78+. f[, ( 6) 479,553.05 4lluch ex?lnnuiion i omounl[citified di eos ion, !hr.'mow,'uppli,v/, Intl al all //gard■ ;)11 lhi■ Line 3 less Line 6 $ (. I / / � If' 1 4pplicuiion and on -)IaliI1ualion.Slice!dial arc 12,1iN ul 0 ((info n rich 111r U11HIn111 crrlilIC u. CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: >'"� 0.00 19,805.00 1 Total changes approved in previous months by Owner $ $ B �� s ( D oL. ')Z it 0.� 0.00 y — -- —.._. Total approved this Month $ $ TOTALS $ 0.00 $ 19,805.00 This Certif not negotiable. The AMOUNT C'EkTII II D is payable only t:, the Contractor 19,805.UU named herein. ssuance, payment and acceptance of payment are witbout piejudicc to any rights of NET CHANGES by Change Order $ the Owner or Contractor under this Contract. REORDER FORM NO.604LS1 1(� �1'Yr Continuation Sheet AIA Document G703-1992 (Instructions on reverse side.) Page 1 of 2 AlA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: 4 containing Contractor's signed Certification, is attached. In tabulations below, amounts are stated to the nearest dollar. APPLICATION DATE: 01/31/2011 Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 01/31/2011 ARCHITECT'S PROJECT NO: 12012 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE ITEM DESCRIPTION OF WORK SCHEDULED PRESENTLY COMPLETED % TO RETAINAGE . VALUE FROM PREVIOUS STORED AND STORED (G + C) (IF VARIABLE) NO APPLICATION THIS PERIOD (NOT IN TO DATE FINISH RATE) (D + E) D OR E) (D+E+F) (C G) 01 104-4100 GENERAL 26,000.00 6,500.00 3,900.00 10,400.00 40.00 15,600.00 1,040.00 CONDITIONS 02 104-4101 BOND 8,000.00 8,000.00 8,000.00 100.00 800.00 03 104-4102 BLOCK LABOR 9,400.00 4,230.00 940.00 5,170.00 55.00 4,230.00 517.00 04 104-4103 BLOCK 2,700.00 1 ,485.0C 270.00 1,755.00 65.00 945.00 175.50 MATERIAL 05 104-4104 EAST FACE 121,430.00 25,500.30 27,928.90 53,429.20 44.00 68,000.80 5,342.92 BRICK LABOR 06 104-4105 EAST BRICK 56,400.00 24,252.00 14,100.0C 38,352.00 68.00 18,048.00 3,835.20 MATERIAL 07 104-4106 SOUTH FACE 104,560.00 15,684.00 15,684.00 15.00 88,876.00 1,568.40 BRICK 08 104-4107 SOUTH BRICK 48,600.00 5,346.00 13,608.00 18,954.00 39.00 29,646.00 1,895.40 MATERIAL 09 104-4108 WEST FACE 115,100.00 1 15,100.00 BRICK LABOR 10 104-4109 WEST BRICK 53,500.00 5,885.00 3,745.00 9,630 00 18.00 43,870.00 963.00 MATERIAL 11 104-4110 WEST 6,500.00 6,500.00 LIMESTONE LABOR 12 104-41 1 1 WEST 24,500.00 22,050.00 2,450.00 24,500.00 100.00 2,450.00 LIMESTONE MATERIAL 13 104-4112 WEST 14,800.00 14,800.00 PAGE TOTALS : 591,490.00 103,248.30) 82,625.90 .00 185.874.20 405,615 80 18 587 47 G703-1992 Continuation Sheet ABA Document G703-1992 (Instructions on reverse side.) Page 2 of 2 AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: containing Contractor's signed Certification, is attached. 4 In tabulations below, amounts are stated to the nearest dollar APPLICATION DATE: 01/31/2011 Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 01/31/2011 ARCHITECT'S PROJECT NO: 1 7012 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE ITEM DESCRIPTION OF WORK SCHEDULED PRESENTLY COMPLETED % RETAINAGE NO. VALUE FROM PREVIOUS STORED AND STORED (G _ C) N (IF VARIABLE) APPLICATION THIS PERIOD (NOT IN TO DATE FINI SH RATE) (D + E) D OR E) (D+E+F) (C G) GRANITE LABOR 14 104-4113 WEST 60,720.00 60,720.00 60,720.00 100.00 6,072.00 GRANITE MATERIAL 15 104-4114 NORTH FACE 80,550.00 20,943.00 47,524.50 68,467.50 85.00 12,082.50 6,846.75 BRICK LABOR 16 104-4115 NORTH BRICK 37,500.00 35,625.00 1,875.00 37,500.00 100.00 MATERIAL 3,750.00 17 104-4116 NORTH 10,900.00 7,303.00 2,180.00 9,483.00 87.00 1,417.00 948.30 LIMESTONE LABOR 18 104-4117 NORTH 41,500.00 41 ,500.00 41,500.00 100 4,150.00 LIMESTONE MATERIAL 19 104-4118 NORTH 9,860.00 8,676.80 8,676.80 88.00 1,183.20 867.68 GRANITE LABOR 20 104-4119 NORTH 40,480.00 40,480.00 40,480.00 100 4,048.00 GRANITE MATERIAL 21 104-4120 ALLOWANCE 25,000.00 10,039.00 22 104-4121 CO#52 TAX -19,805.00 -19,805.00 10,039.00 40.16 14,961.00 1,980.50 EXEMPTION 19,805.00 100.00 -1,980.50 JOB TOTALS : 878,195.00 308,730. 10 ? 134,205.40 .00 442,935.50 50% 435,259.50 44,293.55 I 6703-1992