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HomeMy WebLinkAbout222559 07/30/2013 CITY OF CARMEL, INDIANA VENDOR: 367103 Page 1 of 1 ' ONE CIVIC SQUARE RENASCENT INC CHECK AMOUNT: $101,087.32 CARMEL, INDIANA 46032 935 W TROY AVE INDIANAPOLIS IN 46225 CHECK NUMBER: 222559 CHECK DATE: 7/3012013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 211 4462300 25266 1 101, 087 . 32 NASH BLDG UTILITY REL CONSTRUCTION PROJECT INVOICE DATE: July 10, 2013 COMPANY NAME: Renascent, Inc. AND ADDRESS 935 West Troy Avenue Indianapolis, Indiana 46032 TELEPHONE NO.: (317)-783-1500 FAX NO.: (317)-783-4860 PROJECT NAME: Nash Building Utility Relocation PROJECT NO.: Project No. 13-03 �y�\Q INVOICE NO.: 1 TOTAL EARNINGS TO DATE: $ 112,319.25 MINUS 10% RETAINAGE: (-) 11,231.93 TOTAL EARNED MINUS RETAINAGE: $ 101,087.32 MINUS PREVIOUS PAYMENTS: (-) 00.00 TOTAL AMOUNT DUE: $ 101,087.32 81 Tiffa ryylb o0 Construction Inspector City of Carmel APPLICATION`,AND'CERTIFICATION FOR PAYMENT AIA DOCUMENT.G702 PAGE 1 '..OF 2 TO OWNER: PROJECT: Project 13-03 ;I r APPLICATION N0: .298-AP1 (REVISED) Distribution to: The City of Carmel Nash Building Utility,Relocation; One Civic Square PO 25266 ! t:, ARCHITECT Carmel,IN 46032 PERIOD TO: 6/19/2013 CONTRACTOR FROM CONTRACTOR: ARCHITECT: Renascent, Inc. !T 935 West Troy Avenue Telephone: 317.783.1500 PROJECT NO: Indianapolis, Indiana, 225- = .w Fax Number: 317.783.4860 CONTRACT DATE: 4/10/2013 CONTRA.CTCIR'•S'`-A,r-PL-l�C`ATION FOR PAYMENT :..i a ne undersigned Contractor certifies that to the best of the Contractor's knowledge, shi m!-c!c ; in conr,cction with the Contract. information and belief the Work covered by this Application•for'.Payment has been Coll tin;!auua Shea, MA Dl o,unie!it G703. is±:..ached. completed in accordance with the o+a'U ct Documents,that all;amounts have been paid by the Contractor for Work for whicl previQuZaC iti•iigates for Payir ent were.issued and enr ; payments received from the Own r,,�lid Q rent payment sh'' n•herein is now due. 1. ORIGINAL CONTRACT SUM $ 157,777.00 Nor SgRAHV v F 2. Net change by Change Orders $ 0.00 CONTRACTOR. =; /ANP./ = ary'Pl,61,�, .-HALL ` 3. CONTRACT SUM TO DATE(Line 1 +2) $ 157,777.00 Al S State ofrndi ry 4. TOTAL COMPLETED&STORED TO $ 112,319.25 YCOmmissi FA(. DACE (Column G on G703) ►3v: on•FX ' 5. RETAINAGE: U. a. 10 %of Completed W! rk $ 11,231.93 State of: INDIANA County'of: MA}�0'd (Column D+E on 6703) Subscribed ands o n to before me this 01 day of -'•/� ��� t b. 0 %of Stored Material $ 0:00 Notary Public: r. y C (Column F on G703) My Commission expires: "Total Retainage(Lines 5a+56 or Total in ColumnTof'G703) $ 11,231.93 : ?•ARCHITECT'S;CERTIFICATE-.FOR';PAYMENT 6. TOTAL EARNED LESS RETA[NAGE $ 101,087 ,.?jZ- . ,,;,•,• In accordance with the Contract Documents,based on on-site.observations and the"data (Line 4 Less Line 5 T6(al) comprising the application,the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES^FOR „ , Architect's knowledge inf5rmation`.and•belief the Work has progressed as indicated, PAYMENT(Line 6 from prior Certificate) $ 0.00„ , ,;,r. ,.0he quality of the-Work is -accord'ance,with the Contract:Docuinents,and the Contractor 8. CURRENT PAYMENT DUE $ 101,087.- . '32_ is entitled to payment of the'AMOUNTCERTIFIED. 9. BALANCE TO FINISH;INCLUDING RETAINAGE 56,689.68 X72' (Line 3 less Line 6)-w s_ AMOUNT CE f.,D. :...... . . . . . ..$ f ! t 1 f f ;=, ✓. „ , flttach e a_at__ .af oun cert fed di ers ron:the amp ount a -Yted.,/nitial all i ures on this ( - 1 I 11 I pp I-g" Total changes approved ;,,, 'c>i ,t,,•.f„• ,,,4pplic ion,and o th .Conti uat nt t`that are changed to conform with the amount certified.) in previous months,liy'O}vncr, $0.00 $0.00 ARCI- TECT: Total approved this Month $0.00 $0.00 By: Date: —1/0 3: , ,. TOTALS $0.00 $0.00 f,--,,,i,, -This Certificate is not negotiable. The AMOUNT CERTIFIED s,payable Oily toll he „,Contractor named herein.-Issuance,.payment and acceptance of payment are without Nb t A-HANIrSJ oy,,l�hanve;Vroer $U.UU ,.,,pre3ualce to any ngnts of the owner or.uontractor unoer tnts uontr"act. AIA DOCUMENT G702 APPLICATION'AND'CERTIFICATION FOR PAYMENT 1992 EDITION AIA ©1992 -,,q;,,.<,:TTHE•AMERICAN,INSTITUTE OF ARCHITECTS;1735 NEW YORK'AVE.,N.W.,WASHINGTON,DC 20006-5292 NUA I S�'� AIA DOCUMENT�G703 PAGE 2 OF 2 APPLICATION NO: 29&-AP 1 Contractor's signed certification is attached. APPLICATION DATE: 6/30/2013 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 6/30/201 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: . Nash Building Utility Relocation; 110,125266 F A B C D E F G H I DL:SC:kll,HON UI- \vURK SC'1-IEDULED \VOItK COi`9PLETED MA I'ERIALS TOTAL % BALANCE RETAINAGE Code VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G=C) TO FINISH (IF VARIABLE APPLICATION STORED AND STORED (C-G) RATE) (D+E) (NOT IN TO DATE D OR E)- (D+E+F) 3000 Storm Sewer 69,000.00 0.00 55,00.00 55,200.00 80% 13,800.00 5,520.00 3800 Water 50,000.00 0.00 42,500.00 42,500.00 85/0 7,500.00 4,250.00 4000 Jersey Barriers 14,000.00 0.00 12.600.00 12,600.00 90% 1,400.00 1,260.00 1500 Demo Existing Storm and Water• 6,000.00 0.00 0,00 0.00 0% 6,000.00 0.00 4000 New Sidewalk and curb 12,700.00 0.00 0.00 0.00 0% 12,700.00 0.00 1400 Erosion Control 4,077.00 0.00 1,019.25 1,019.25 25% 3,057.75 101.93 9250 Mob and Demob 2.000.00 0.00 1,000.00 1,000.00 50% 1,000.00 100.00 GRAND TOTALS 157,777.00 0.00 112,319.25 0:0.0 112,319.25 71:19"/ 45,457..75: 11,231.93 AIA DOCUMENT G703 CONTINUATION SHEET FOR G702- 1992 EDITION AIA:IQ 1992' 6703-1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,N.W.WASHINGTON,D.C.20006-5292 RECEIPT, WAIVER,AND RELEASE OF LIEN RIGHTS PartialFx Final Upon receipt of check in paymt of the below application, the undersigned acknowledges the payment and satisfaction in full for all labor, services and materials furnished or supplied up to and including the date: 6/19/2013 Application 298-API relating to use, to be used, or contributing to the construction, addition, or development of the work or improvements concerning that certain real property, commonly known as: Project No: Renascent Project#298 Project Name: Nash Building Utility Relocation; Project 13-03 PO 25266 Location: Carmel, IN Owner or General Contractor: City of Carmel The undersigned hereby expressly waives, releases, and discharges the real property described above and the Owner thereof, of and from any and all claims for mechanics' liens and rights to any such claim which the undersigned has or may have for labor, services, or materials or otherwise in connection with said work of improvements and every part thereof up to and including the date hereof and does hereby waive and release any and all right that the undersigned now has or may have to levy or place any mechanics' lien, attachment lien, judgment lien, or execution lien on or against the real property described above for any existing indebtedness of the Owner of said real property to the undersigned. Subcontractor/Supplier: Renascent, Inc. Amount: $101,087.33 Signature: A_��L 0-kAA A Name(printed) Linda Campbell Title: President Date: 7/312013 I WITH SS by hand a d official seal, this 3 Day of 20 , Notary Public: Name (printed): 1�1-� �� _. ,.. ., :'..v'.',.��..L 1. 'v•..V v °=aT°- • SARAH C.HALL County of Residence: , J ',/ Notary Public,State of Indiana Commission expires: l" t SEAL My Commission Expires 31812019 Renascent,Inc.dba Campbell Land Development dba Construction Waste 935 W.Troy Ave. Indianapolis,IN 46225 317.783.1500 Fax 317.293.7108 Accounting @callCW.com CONSTRUCTION PROJECT INVOICE DATE: July 10, 2013 COMPANY NAME: Renascent, Inc. AND ADDRESS 935 West Troy Avenue Indianapolis, Indiana 46032 TELEPHONE NO.: (317)-783-1500 FAX NO.: (317)-783-4860 PROJECT NAME: Nash Building Utility Relocation PROJECT NO.: Project No. 13-03 INVOICE NO.: 1 TOTAL EARNINGS TO DATE: $ 112,319.25 MINUS 10% RETAINAGE: (-) 11,231.93 TOTAL EARNED MINUS RETAINAGE: $ 101,087.32 MINUS PREVIOUS PAYMENTS: -) 00.00 TOTAL AMOUNT DUE: $ 101,087.32 I � T1ffa o0 Construction Inspector City of Carmel APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE 1 OF 2 TO OWNER: PROJECT: Project 13-03 APPLICATION NO: .298-AP1 (REVISED) Distribution to: The City of Carmel Nash Building Utility Relocation X' OWNER One Civic Square PO 25266 ARCHITECT Carmel, IN 46032 PERIOD TO: 6/19/2013 CONTRACTOR FROM CONTRACTOR: ARCHITECT: Renascent,Inc. 935 West Troy Avenue Telephone: 317.783.1500 PROJECT NO: Indianapolis. Indiana 46225 Fax Number: 317.783.4860 CONTRACT DATE: 4/10/2013 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, :!s shu\ :: ! .! .«, in colinectio:: with the Cor.traa information and belief the Work covered by this Application for Payment has been Contim::t;:o: i:cc:, AIr. -etu?:_nt G703, is:'t?c.ched. completed in accordance with the cwt�t�t Documents.that all amounts have been paid by the Contractor for Work for whic prevj uZQerti orates for Payment were issued and 6 Ar ••.,, .�.v payments received from the Own r,Ahd $at»rent payment shown herein is now due. 1. ORIGINAL CONTRACT SUM $ 157,777.00 feii'i `_ V SR 2. Net change by Change Orders $ 0.00 CONTRACTOR: / Notary Public C,/� �"/ANP ublic, ABC 3. CONTRACT SUM TO DATE(Line 1 +2) $ 157,777.00 _ ° „" M SEA State Of tndi 4. TOTAL DDATE (Column G on G70 ) TO $ 112,319.25 By y COmmI S /O p d3 5. RETAINAGE: a. 10 %of Completed Work $ 11,231.93 State of: iNDIANA County of: M (Column D+E on G703) Subscribed ands o n to before me this day of J-io i b. 0 %of Stored Material $ 0.00 Notary Public: (Column F on G703) My Commission expires: Total Retainage(Lines 5a+5b or g ' Total in Column I of G703) $ 11,231.93 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 101,087.J;e,7jZ In accordance with the Contract Documents,based on on-site observations and the data (Line 4 Less Line 5 Total) comprising the application,the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge,information and belief the Work has progressed as indicated, PAYMENT(Line 6 from prior Certificate) $ 0.00 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE $ 10 1,087,3e. 3Z is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE 56,689.68 3Z (Line 3 less Line 6) AMOUNT CE I D. . . . . . . . . . .$ _ (Attach e- anation J'a our:)certified differs from the a^mount aapplied. Initial all figures on this Total changes approved .4pp/ic ion and a th Conti oat n t that are changed to conform with the amount certified.) in previous months by Owner $0.00 $0.00 ARC TECT: 'total approved this Month $0.00 $0.00 By: Date: TOTALS $0.00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable oily to the Contractor named herein. Issuance,payment and acceptance of payment are without Nh 1 UHANhbJ D}'t✓nange uraer $0M prejuoice to any ngnts of the owner or t_,ontractor uncier this lontract. AIA DOCUMENT G702 APPLICATION AND CERTIFICATION FOR PAYMENT 1992 EDITION-AIA ©1992 - THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE_N.W.,WASHINGTON,DC 20006-5292 CONTINUATION SKEET AIA DOCUMENT G703 PAGE 2 OF 2 APPLICATION NO: 298-API Contractor's signed certification is attached. APPLICATION DATE: 6/30/2013 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 6/30/2013 Use Column I on Contracts where variable retainage for line iterns may apply. ARCHITECT'S PROJECT NO: . Nash Building Utility Relocation; PO 725266 A B C D E F G H l (_o>t 51 11ii 155 N UI V U1,K SCHEDULED WORK COMPLETED MATERIALS 'TOTAL % BALANCE RETAINAGE Code VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G_C) TO FINISH (IF VARIABLE APPLICATION STORED AND STORED (C-G) RATE) (D+E) (NOT IN TO DATE D OR E) (D+E+F) 3000 Storm Sewer 69.000.00 0.00 55,200.00 55,200.00 80% 13,800.00 5,520.00 3800 Water 50,000.00 0.00 42,500.00 42,500.00 85% 7,500.00 4,250.00 4000 Jersey Barriers 14,000.00 0.00 12.600.00 12,600.00 90% 1,400.00 1,260.00 1500 Demo Existing Storm and Water 6,000.00 0.00 0.00 0.00 0% 6,000.00 0.00 4000 New Sidewalk and curb 12,700.00 0.00 0.00 0.00 0% 12,700.00 0.00 1400 Erosion Control 4,077.00 0.00 1,019.25 1,019.25 25% 3,057.75 101.93 9250 Mob and Demob 2.000.00 0.00 1,000.00 1,000.00 50% 1,000.00 100.00 GRAND TOTALS 1 157,777.00 0.00 1 112,319.25 0.00 112,319.25 1 71.19% 45,457..75 1 11,231.93 AIA DOCUMENT G703-CONTINUATION SHEET FOR G702 1992 EDITION-AIA ;D 1992 _ G703-1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,N.W.WASHINGTON,D.C.20006-5292 RECEIPT, WAIVER,AND RELEASE OF LIEN RIGHTS Partial 7x Final F7 Upon receipt of check in paymt of the below application, the undersigned acknowledges the payment and satisfaction in full for all labor, services and materials furnished or supplied up to and including the date: 6/19/2013 Application 298-AP1 relating to use, to be used, or contributing to the construction, addition, or development of the work or improvements concerning that certain real property, commonly known as: Project No: Renascent Project#298 Project Name: Nash Building Utility Relocation; Project 13-03 PO 25266 Location: Carmel, IN ` Owner or General Contractor: City of Carmel The undersigned hereby expressly waives, releases, and discharges the real property described above and the Owner thereof, of and from any and all claims for mechanics' liens and rights to any such claim which the undersigned has or may have for labor, services, or materials or otherwise in connection with said work of improvements and every part thereof up to and including the date hereof and does hereby waive and release any and all right that the undersigned now has or may have to levy or place any mechanics' lien, attachment lien, judgment lien, or execution lien on or against the real property described above for any existing indebtedness of the Owner of said real property to the undersigned. Subcontractor/Supplier: Renascent, Inc. Amount: $101,087.33 Signature: 0 kAJ Name(printed) Linda Campbell Title: President Date: 7/3/2013 WITH SS b hand a d official y � o a seal, this Day of 20� , Notary Public: Name (printed): . .P�4 SARAH C. HALL County of Residence: ��, ,ck-(L,t f �-0- t-,�k"-z- , Notary Public,State of Indiana Commission expires: 2 . _t SEAL MY CammisMon Expires 3/8/2019 Renascent,Inc.dba Campbell band Development dba Construction Waste 935 W.Troy Ave. Indianapolis,IN 46225 317.783.1500 Fax 317.293.7108 Accounting @callCW.com CONSTRUCTION PROJECT INVOICE DATE: July 10, 2013 COMPANY NAME: Renascent, Inc. AND ADDRESS 935 West Troy Avenue Indianapolis, Indiana 46032 TELEPHONE NO.: (317)-783-1500 FAX NO.: (317)-783-4860 PROJECT NAME: Nash Building Utility Relocation PROJECT NO.: Project No. 13-03 INVOICE NO.: 1 TOTAL EARNINGS TO DATE: S 112,319.25 MINUS 10% RETAINAGE: (-) 11,231.93 TOTAL EARNED MINUS RETAINAGE: S 101,087.32 MINUS PREVIOUS PAYMENTS: (-) 00.00 TOTAL AMOUNT DUE: S 101,087.32 Tiffa fYy o 0 Construction Inspector City of Carmel APPLI,C-ATION,AND'-CL-P,,TIFICATION FOR PAYMENT AIA DIOCUMENT.G702 PAGE I TO OWN-ER: PROJECT: Project 13-03 APPLICATION NO: .298-API (REVISED) Distribution to: The City of Carmel Nash Building Utility,ReldcafioTn; caX3a GIM/NER- One Civic Square PO 25266 ARCHITECT Carmel, IN 46032 PERIOD TO: 6/19/2013 CONTRACTOR FROM CONTRACTOR: ARCHITECT: Renascent, Inc. 935 West Troy Avenue Telephone: 3 17.783.1500 PROJECT NO: Indianapolis, Indiana A6225 " * - ;-,:I Fax Number: 317.783.4860 CONTRACT DATE: 4/10/2013 CONTRACTOR-'S-"',,kF'P "IC'A-�TION FOR PAYMENT 7 The,L111 dersi P-ned Contractor,cerii fies that to the best of the Confr'aLtor's knowledge, in Coll?'-CCLi011 With the C011ti-LICt. information and belief the Work covered by this Applicatio,n4delPayment has been -dance with ac all�arnounts have been paid by Sllcct, /\lyl, Doc'uilie!it G703, is i!'Lla":hed. completed in accot "I"c 14 1 DOCLI111CIltS,that� ntr hic, �r4iLc�ates for ayi the Contactor for Work fcir P, nent wer'e,issucd and payments received from the Own r,Ad. Qaifrrent paynichvsbbwn herein is now due. 1. ORIGINAL CONTRACT SUM 157,777.00 S4R.4/1� 2. Net change by Change Orders 0.00 CONTRACTOR: "00tary 1cC. , 157,777.00 df/17�`�U,�-3. CONTRACT SUM TO DATE(Line I +2) Afy omm. 112,319.25 isti 4. TOTAL COMPLETED&STORED TO DATE (Column G on G103) By: 5. RETAINAGE: . ..... 'd Wbrk 11,231.93 J State of: INDIANA Cou t`of:.'M a. 10 %ofComplete' $ (Column D+E on G703) Subscribed ands o n to before Inc this day of b. 0 %of Stored Material 0.00 Notary Public: (Column F on G763) My Commission expires: Total Retainage(Lines 5a 5b or Total in Column,1,of,G703) 11,231.93 ,i,ARGH'ITECT'S;GE'RT1,FIGATE FOR':PA MENT 6. TOTAL EARNED LESS IR-JE TAI'NA6E 101,087`3 •n_3:L In accordance with the Contract Docurrients,based on on-site observations and the data (Line 4 Less Line 5 Total) comprising the application,the,'Architiect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES.FOR Architect's knowledge' inf6rinatibhl.and belief the Work has prog ess d as indicated, PAYMENT(Line 6 froii i,pridr Certificate) Q.OQ,, ,,;,the quality of the Work is.i rf�accoi:dlihce,with the Contract;Documents,and the Coatriktor 8. CURRENT PAYMENT DUE 10 1 1 U8-7,-A,32 is entitled to payment of the AMOUNT-CERTIFIED. 9. BALANCE TO I--INi5i4,',INCLUDING RETAINAGE 56,689.68 ' 6) AM, lot, (Line 3 less Lin 0 TCE I D. ... . . . .. . . . U 2 U-1ANUE UKULK --AUDI I lums DLUUU I IUM 7 e anation ITa . lin certified diJJersJron1 the iniount-apolied-Initia7,11 res on this CE 7 r fe'd$ �te r IMARY '0' t ed to,con/brm'with the amount certified.) ion-and a th Con*ti tat' nf that are changed Total changes approved f t, n. in previous months'�by'Mhc'r, $0.00 $0.00, ARCFJ�CT: 'total approved this M06111 $0.00 $0.00, By: = Date' ily t"-&- TOTALS $0.09 -This Certificate is not negotiable. The AMOUNT CERTI FIED'isl payable o $9.00 t ertificate named herein. issuance,payment and acceptance ofpayment are withdut $U.00 l,..!prcjuaice to any rignts or the uwner.or.contractor under urns C ontract. AIA DOCUMENT G702 -APPCICATibN:AND'CERTI'FICATION FOR PAYMENT 1992 EDITION AIA (91962 ARCHITECTS,1735 NEW YORK AVE.,N.W.,.WASHINGTON,•DC 20006-5292 ?it OF ARCH! E CONTINUATION SHEET AJA'D0CUMENTG703 PAGE 2 OF 2 APPLICATION NO: 298-API Contractor's signed certification is attached. APPLICATION DATE: 6/30/2013 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 6/30/201 Use Column I on Contracts where variable retainage for line items may apply. A.RCHITECT'S PROJECT NO: . Nash Building Utility Relocation; PO#252(16 A B C D E F G FI I Lull UI SLILI i ION OF \\'UKK SCHEDULED \'URK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE Code VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G C) TO FINISH (IF VARIABLE APPLICATION STORED AND STORED (C-G) RATE) (D+E) (NOT IN TO DATE D OR E) (D+E+F) 3000 Storm Sewer 69,000.00 0.00 552200.00 55,200.00 80% 13,800.00 5,520.00 3800 Water 50,000.00 0.00 =12,500.00 42,500.00 85% 7,500.00 4,250.00 4000 Jersey Barriers 14,000.00 0.00 12,600.00 12,600.00 90% 1,400.00 1,260.00 1500 Demo Existing Storm and Water 6,000.00 0.00 0.00 0.00 0% 6,000.00 0.00 4000 New Sidewalk and curb 12,700.00 0.00 0.00 0.00 0% 12,700.00 0.00 1400 Erosion Control 4,077.00 0.00 1,019.25 1,019.25 25/° 3,057.75 101.93 9250 Mob and Demob 2,000.00 0.00 1,000.00 1,000.00 50% 1,000.00 100.00 GRAND TOTALS 157,777.00 0.00 112,319.25 0.00 112,319.25 71.19% 45,457.75 11,231.93 AIA DOCUMENT G703 CONTINUATION SHEET FOR G702 1992 EDITION AIA--0 1992 C70$-1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,N.W.WASHINGTON,D.C.20006-5292 RECEIPT, WAIVER, AND RELEASE OF LIEN RIGHTS Partial�x Final Upon receipt of check in paymt of the below application, the undersigned acknowledges the payment and satisfaction in full for all labor, services and materials furnished or supplied up to and including the date: 6/19/2013 Application 298-AP1 relating to use, to be used, or contributing to the construction, addition, or development of the work or improvements concerning that certain real property, commonly known as: Project No: Renascent Project#298 Project Name: Nash Building Utility Relocation; Project 13-03 PO 25266 Location: Carmel, IN Owner or General Contractor: City of Carmel The undersigned hereby expressly waives, releases, and discharges the real property described above and the Owner thereof, of and from any and all claims for mechanics' liens and rights to any such claim which the undersigned has or may have for labor, services, or materials or otherwise in connection with said work of improvements and every part thereof up to and including the date hereof and'does hereby waive and release any and all right that the undersigned now has or may have to levy or place any mechanics' lien, attachment lien, judgment lien, or execution lien, on or against .the real property described above for any existing indebtedness of the Owner of said real property to the undersigned. Subcontractor/Supplier: Renascent, Inc. Amount: $101,087.33 Signature: Name(printed) Linda Campbell Title: President Date: 7/312013 WITN SS by hand a d official seal, this �.� Day of 20 I Notary Public: Name(printed): L '� e �'I_L r •_ County of Residence: �V SARAH C.HALL v' ,� • �` Notary Public,State of Indiana Commission expires: 2, . 1 '_t SEAL ,�►s+w�,.• My Commission Expires 31812019 M.y\ Renascent,Inc.dba Campbell Land Development dba Construction Waste 935 W.Troy Ave. Indianapolis,IN 46225 317.783.1500 Fax 317.293.7108 Accounting@callCW.com i� Prescribed by State Board of Accounts City Form No.201(Rev.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. Payee Renascent Inc Purchase Order No. 935 West Troy Avenue Terms Indianapolis, IN 46032 Date Due Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s) Amount 7/10/2013 1 Nash Building Utility Relocation Construction $ 101,087.32 Total $ 101,087.32 1 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 NC WARRANT NO. Renascent Inc ALLOWED 20 935 West Troy Avenue IN SUM OF $ Indianapolis, IN 46032 $ 101,087.32 ON ACCOUNT OF APPROPRIATION FOR Board Members Po#or DEPT# INVOICE NO. ACCT#/TITL AMOUNT DEPT# I hereby certify that the attached invoice(s), 25266 1 211-4462300 $ 101,087.32 or 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 i / 7/29/2013 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund