HomeMy WebLinkAbout223684 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 363909 Page 1 of 1
ONE CIVIC SQUARE VILLAGE FINANCIAL,LLC
CARMEL, INDIANA 46032 ONE PEDCOR SQUARE CHECK AMOUNT: $8,657.00
r=� 770 3RD AVE SW
CHECK NUMBER: 223684
CARMEL IN 46032
CHECK DATE: 8127/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 4460877 31330 82213 8, 657 . 00 AWNING FOR MOTOR CT
*VILLAGE ]FINANCIAL, LLC
INVOICE
To: Carmel Redevelopment Commission
7603 d Avenue, S.W.
Carmel, Indiana 46032
Invoice Amount: $8,657.00 ($8,224.15 + $432.85)
Payable to: Village Financial, LLC
770 3rd Avenue SW
Carmel, Indiana 46032
This invoice is to reimburse Village Financial, LLC for paying Sommer Awning Group $8,657
for work related to the Motor Court stairs under the PAC Millwork Installment Contract. The
contractor was not willing to wait for payment; therefore, Village Financial, LLC came out of
pocket to get the contractor paid.
Per the request of the Clerk Treasurer, funds allocated for payment of this vendor invoice
($8,657) were transferred from Village Financial, LLC to the Clerk Treasurer's office on March
8, 2013.
One Pedcor Square, 770 3.d Avenue SW J—+)+}s Carmel, IN 46032)1 )+ (317) 587-0320 Fax(317)218-2665
VENDOR: SOMAWN CHECK: 0000712344 DATE: 8/22/2013
REMIT T0: SOMMER AWNING GROUP COMMENT:
VOUCHER DISCOUNT
I Mtr Crt Stair 6/13/2013 0000348889 eDocAPCodingID:322931 8,224.15 0.00 8,224.15
2 Mtr Crt Stair 6/13/2013 0000348890 eDocAPCodingID: 322934 432.85 0.00 432.85
FUND E TOTAL., 8,657.00 0.00 8,657.001
PEDCOR COMPANIES
VENDOR: SOMAWN CHECK: 0000712344 DATE: 8/22/2013
REMIT TO: SOMMER AWNING GROUP COMMENT:
INVOICE
- AMOUNT DISCOUNT NETAMOUNT,
1 Mtr Crt Stair 6/13/2013 0000348889 eDocAPCodingID:322931 8.224.15 0.00 8,224.15
2 Mtr Crt Stair 6/13/2013 0000348890 eDocAPCodingID:322934 432.85 0.00 432.85
FUND E 8,657.00 0.00 8,657.00
PEDCOR COMPANIES
r • ;MRS 14 Imm • •
Pedcor Cornpan�es FU�+1D E(1499Q7476 UFB) UNITED FIDELITY BANK No 00 0077 2344
7T0 3rd Ave SW 1'8 NW Fourth Street
, Carmel 1111 46032 K Evansville IN= 47708 = ,
P
Y
s
NAaZ 71 7166/2863�,
8/22/2013
657 00 t
EI ht thousand s
i F
gPAY� g lx hundretl fifty seven and xX / 100�Dollars �`
TO THE SOMMER AWNING GROUP
ORDER ' 1160 WEST 116TH STREET
OF k Indianapolis, IN 46202
USA
E
AUTHORIZED SIGNATURE
e r
Y 4"
Ila00007 12 3L,4110 1028637b6631: 90890L,Ila
APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF TWO
TO OWNER: ✓ CRL PROJECT: Motor Court Stairs APPLICATION NO: 2 Distribution to:
30 W. t\kPt%N ST. S1A\1-7- 'a.Z.0 =OWNER
Carmel,IN 46032 Carmel, Indiana 46032 =ARCHITECT
11116146111r-
1160 PERIOD TO: 4/18/2013=CONTRACTOR
FROM CONTRACTOR: Sommer Awning Group VIA CONSTRUCTION MANAGER:
W 1 16th Street Signature Construction, LLC 0 j
Indianapolis, IN 46202 720 Third Avenue, SW PROJECT NO:
(317)257-4300 Cannel, Indiana 46032 "•'?
CONTRACT LATE: 10/22/2012
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet,AIA Document G703,is attached. completed in accordance with the Contract Documents,that all amounts have been paid by
the Contractor for Work for which previous Certificates for Payment were issued and
payments received from the Owner,and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM $ 8,657.00
2. Net change by Change Orders $ 0.00 COPJTEZ
3. CONTRACT SUM TO DATE(Line 1 t 2) $ 8,657.00 G/
4. TOTAL COMPLETED&STORED TO DATE $ 8,657.00
By: Date:
5. RETAINAGE:
a. 5 %of Completed Work $ 432.85 Subscribed and sworn to before me this 3rh day of j VAS C
(Column D+E on G703)
b. 5 %of Stored Material $ 0.00
(Column F on G703)
Total Retainage(Lines 5a+5b or
Total in Column I of G703) $ 432.85 ENGINEER'S CERTIFICATE FOR PAYMENT
6. TOTAL EARNED LESS RETAINAGE $ 8,224.15 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 Less Line 5 Total) comprising the application,the Engineer certifies to the Owner that to the best of the
7. LESS PREVIOUS CERTIFICATES FOR Engineer's knowledge,information and belief the Work has progressed as indicated,
PAYMENT(Line 6 from prior Certificate) $ 8,224.15 the quality of the Work is in accordance with the Contract Documents,and the Contractor
nCURRENT PAYMENT DUE 432.85 is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH,I .UDING RETAINAGE $ 0.00
(Line 3 less Line 6) AMOUNT CERTIFIED $
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount rtified differs fi-om the amount applied. Initial all figures on this
Total changes approved Application and arlthe-cet1 7 a ion Sheet that are changed to conform with the amount certified
in previous Change Orders $0.00 $0.00 1 h I R�.
Total approved this Change Order $0.00 $0.00 By: \ Date:
TOTALS $0.00 $0.00 This Ce' I ate i not ne tiable. re AMOUNT CER"T1F1ED is payable my o the
Contract name herem.Issuance,payment and acceptance of payment a e w1 out
NET CTIANGES by Change Order $0.00 prejudice any iglus of the Owner or Contractor under this Contract.
AIA DOCUMENT G702 APPLICATION AND CERTIFICATION FOR PAYMENT 1992 EDITION AIA 01992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,N.W.,WASHINGTON,OC 20006-5292
Users may obtain validation of this document by requesting a completed AIA Document D401 -Certification of Document's a Licensee.
STEPHEN L BATES
i ARY PUBLI C
SEAL
JOHNSON NTY,STATE OF INDIANA
COMSION NO.@35754
/1�0 I/tj h`� MY COMMISN EXPIRES MAY 29.2n�n
G703 CONTINUATION SHEET
Page 2 of 2
To: From: Project: Application No.: 2
Signature Construction,IXC Sommer Awning Group Motor Court Stairs Application Date:
720 Third Avenue,SW 1160 W 116th Street Period To:
Carmel,Indiana 46032 Indianapolis,IN 46202 Carmel,Indiana 46032 Engineer's Project No.: 0
A 13 C D E I G 11 I
Work Completed Materials Total
Presently Completed Balance Retainage
Item Scheduled From Previous Stored and Stored % 'I'0 If
# Description of Work Value Application This Period (Not in "ro Date (G/C) Finish Variable
D or E) (D+E+F) (C-G)
1 Awning 8,657.00 8,657.00 0,00 0.00 8,657.00 100% 0.00 0.00
0.00 0.00 0.00 0.00 #DIV/0! 0.00 0.00
0.00 0.00 0.00 OAO #DIV/0! 0.00 0.00
0.00 0.00 0.00 0.00 #DIV/0! 0.00 0.00
0.00 0.00 0.00 0.00 4 DIV/0! 0.00 0.00
0.00 0.00 0.00 0.00 #DIV/0! 0.00 0.00
0.00 0.00 0,00 0.00 #DIV/0!. 0.00 0.00
8,657.00 8,657.00 0.00 0.00 8,657.00 100% 0.00 0.00
INTERIM LIENICLAIM WAIVER
From:. cA b �.���.?�rvr CR��il/i�1G �,2v L) Project: 114[) ( U F°s ('0 C-) T
/ ��ve/rvee o nrm�imny eiease) r io�eci asmci --
U...V y_ /(p / H J T. Carmel. IN
"� - esm9ss�daress� ro)ect a oresa)
Z/v D 14. /J
A) _ -7 ''i 1P . oe)
Contact Person: LPf1En� yam%ES Project Manager:
Contact Telephone: 3f 7: 25 7-./96 9 Project Telephone:
CONDITIONAL RELEASE UNCONDITIONAL RELEASE
The undersigned does hereby acknowledge that The undersigned does hereby acknowledge that the
upon receipt by the undersigned of a check from(Name of undersigned hac received progress payments in the sum
Firm writing check): The Pedcor Companies of S_ Y 3 2. Qys`'�
in the sum of S for iabor, services, equipment or materials famished to the
and when the check has been properly endorsed and has above referenced jch and does hereby release pro tanto
been paid by the bank upon which it was drawn, this any and all claims and rights of lien which the
document shall become effective to release pro tanto any undersigned has on the above referenced job. This
and all claims and rights o, iien which the undersigned release covers a(( payment for labor services, equipment,
has on the above referenced job. This release covers a materials furnished and/or claims to the above referenced
progress payment for labor, services, equipment job through (date)
materials furnished and/or claims through date) only and does not cover any retention or items fumished
after that date.
only and does not.cover any retention or items furnished
after that date. Before any recipient of this document NOTICE: THIS DOCUMENT WAIVES RIGHTS
relies on it said party should verify evidence of payment to UNCONDITIONALLY AND STATES THAT YOU HAVE
the undersigned. BEEN PAID FOR GIVING UP THOSE RIGHTS. THIS
DOCUMENT 1S ENFORCEABLE AGAINST YOU IF YOU
SIGN IT, EVEN IF YOU HAVE NOT BEEN PAID. IF YOU
HAVE NOT BEEN PAID, USE A CONDITIONAL
RELEASE: FORM.
I CERTIFY UNDER PENALTY nP PERJURY UNDER
LAWS OF THE STATE OF __ THAT THE I CERTIFY UNDER PENALTY OF PERJURY UNDER
ABOVE IS A TRUE AND CORRECT STA i EMENT. LAWS OF THE STATE OF THAT THE
ABOVE iS A TRUE AND CORRECT STATEMENT,
Signature:
Signature:
orczad orpnrace ce! eRneruwner)
u onzetl oipo . ,;cenranne; caner)
Dated this day of
Dated this 13 N day of_,10AI C
at: -
,
Subscribed and sworn before me day and year first above at: � C'c C A41 LroAl
written: Subscribed and sworn before me day and year first above
written:
Notary Public
My commission expires : Notary Publi
My commission expires : S z �2 n,;
I
STEPHEN( 8ATS3
NOTARY PUSUC
SEAL
JOHNSON COUNTY,STATE OF INDIANA
COMMISSION NO.635754
MY COMMISSION EXPIRES MAY 29,2020
APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF TWO
TO OWNER: C.PIC PROJECT: Motor Court Stairs APPLICATION NO: I Distribution to:
30 W• lAh\YO IS-T. SutjT& 2.2.0 =OWNER
Cannel,IN 46032 Carmel,Indiana 46032 =ARCHITECT
,616, PERIOD TO: 4/18/2013 CONTRACTOR
FROM CONTRACTOR: Sommer Awning Group VIA CONSTRUCTION MANAGER:
1160 W l 16th Street Signature Construction,LLC ✓�
Indianapolis,IN 46202 720 Third Avenue,SW s PROJECT NO:
(317)257-4300 Carmel, Indiana 46032
CONCT DATE: 10/22/2012
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet,AIA Document G703,is attached. completed in accordance with the Contract Documents,that all amounts have been paid by
the Contractor for Work for which previous Certificates for Payment were issued and
payments received from the Owner,and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM $ 8,657.00
2. Net change by Change Orders $ 0.00 CONTRACTOR:
3. CONTRACT SUM TO DATE(Line I±2) $ 8,657.00
4. TOTAL COMPLETED&STORED TO DATE $ 8,657.00
By: ✓ Date:
5. RETAINAGE:
a. 5 %of Completed Work $ 432.85 Subscribed and sworn to before me this tit day of Ud Lf vZ J
(Column D+E on G703)
b. 5 %of Stored Material $ 0.00
(Column F on G703)
Total Retainage(Lines 5a+5b or
Total in Column I of G703) $ 432.85 ENGINEER'S CERTIFICATE FOR PAYMENT
6. TOTAL EARNED LESS RETAINAGE $ 8,224.15 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 Less Line 5 Total) comprising the application,the Engineer certifies to the Owner that to the best of the
7. LESS PREVIOUS CERTIFICATES FOR Engineer's knowledge,information and belief the Work has progressed as indicated,
PAYMENT(Line 6 from prior Certificate) $ 0.00 the quality of the Work ii in accordance with the Contract Documents,and the Contractor
8. RENT PAYMENT DUE 8,224.15 is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINIS LUDING RETAINAGE $ 432.85
(Line 3 less Line 6) AMOUNT CERTIFIED $
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amoturt certified dif/ers from the amount applied. Initial all figures on this
Total changes approved Application and or7dze C lion Sheet that are changed to conform with the amount certified
in previous Change Orders $0.00 $0.00 91NFl fr
Total approved this Change Order $0.00 $0.00 By: Date:
TOTALS $0.00 $0.00 This Certifica is not 1 gotil le.
The AMOUNT CERTIFIED is payabl on to the
lbn[ractor nan d here r.Issuance,payment antl acceptance of payment are wlthoul
NET CHANGES by Change Order $0.00 prejudice to any i ht f the Owner or Contractor under this Contract.
AIA DOCUMENT G702-APPLICATION AND CERTIFICATION FOR PAYMENT 1992 EDITION*AIA ®1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 YORK AVE.,N.W.,WASHINGTON,DC 20006-5292
Users may obtain validation of this document by requesting a completed AIA Document D401 -Certification of Document's Authenti ity from the BATES
NOTARY PUBLIC
SEAL.
JOHNSON COUNTY,STATE OF INDIANA
_ COMMISSION NO.635754
/1/0 1 /f tz L MY COMMISSION EXPIRES MAY 29,2020
G703 CONTINUATION SHEET Page 2of2
To: From: Project: Application No.: 1
Signature Construction,LLC Sommer Awning Group Motor Court Stairs Application Date:
720 Third Avenue,SW 1160 W 116th Street Period To:
Carmel,Indiana 46032 Indianapolis,IN 46202 Carmel,Indiana 46032 Engineer's Project No.: 0
A B C D E F G 11 1
Work Completed Materials Total
Presently Completed Balance Retainage
Item Scheduled From Previous Stored and Stored % To If
# Description of Work Value Application This Period (Not in To Date (G/C) Finish Variable
D or E) (D+E+F) (C-G)
1 Awning 8,657.00 0.00 8,657.00 0.00 8,657.011 1001/6 0.00 432.85
0.00 0.00 0.00 0.00 #DIV 10! 0.00 0.00
0.00 0.00 0.00 0.00 #DIV/0! 0.00 0.00
0.00 0.00 0.00 0.00 #DIV/0! 0.00 0.00
0.00 0.00 0.00 0.00 #DIV/0! 0.00 0.00
0.00 0.00 0.00 0.00 #DIV/0! 0.00 0.00
0.00 0.00 0.00 0.00 #DIV/0! 0.00 0.00
8,657.00 0.00 8,657.00 0.00 8,657.00 100% 0.00 432.85
INTERIM LIEN/CLAIM WAIVER,
64oLIP zL C
Fromi, GAio.v SO A,me .u � T t / �
a nrm ivnx] a eaee� l OjeL1 asmej
y yV / (p / H T. Carmel. IN
usmess duress} 'rojecl aaresa}
/M) �c� -_IS .— /J
iry,'AaM,4jP l,❑ael
Contact Person:S rLP�Jk yam%6�S Project manager:
Contact Telephone: 31-7'--)S 7— /8'6 9 Project Telephone
CONDITIONAL RELEASE UNCONDITIONAL RELEASE
The undersigned does hereby acknowledge that The undersigned does hereby acknowledge that the
upon receipt by the undersigned of a check from(Name of undersigned hm6 received progress payments in the sum
Firm writing check): The Pedcor Companies of$
in the sum of S us for iabor, services,equipment or materials furnished to the
and when ti-le check has been properly endorsed and has above referenced job and does hereby release pro tanto
been paid by the bank upon which it was drawn, this any and all claims and rights of lien which fhe
document shall become effective to release pro Canto any undersigned has on the above referenced job. This
and all claims and rights of lien which the undersigned release covers all payment for labor services, equipment,
has on the above referenced job. This release covers a materials furnished and/or claims to the above referenced
progress payment for labor, services, equipment, job through (date)
materials furnished and/or claims through (date) only and does not cover any retention or items furnished
after that date.
only and does not.cover any retention or items furnished
after that date. Before any recipient of this document NOTICE: THIS DOCUMENT WAIVES RIGHTS
relies on it said party should verify evidence of payment to UNCONDITIONALLY AND STATES THAT YOU HAVE
the undersigned. BEEN PAID FOR GIVING UP THOSE RIGHTS. THIS
DOCUMENT IS ENFORCEABLE AGAINST YOU IF YOU
SIGN IT, EVEN IF YOU HAVE NOT BEEN PAID. IF YOU
HAVE NOT BEEN PAID, USE A CONDITIONAL
RELEASE FORM.
I CERTIFY UNDER PENALTY OF PERJURY UNDER
LAWS OF THE STATE OF y/dljAdJA THAT THE, I CERTIFY UNDER PENALTY OF PERJURY UNDER
ABOVE i5 A RUE AND CORRECT STATEMENT. LAWS OF THE STATE OF THAT THE
ABOVE IS A TRUE AND CORRECT STATEMENT,
Signatur
Signature:
orxatl rporare e0r ertnar ner
t�"NUmonzed orpc..Cr „certranne; wner)
Dated this S day of J GLV C ,
Dated this day of—
a*:16 66 ty 14 Ot P
at:
Subscribed and sworn before me day and year first above
written: Subscribed and svrom ' re me day and year first above
written:
Notary Publ c
My commission expires : 0?!?2(D Nat Publ 5
My commission expires:
STEPHEN L BATES
NOTARY PUBUC
SEAL
JOHNSON COUNTY,STATE OF IN
COMMISSION N0.635754
MY COMMISSION EXPIRES MAY29,2020
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
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 /
VII-A�9 hh�hCiC(1 Jt.LL:6 Purchase Order No.
-770 .3rd Ave. S Terms
(arm e 1 , _T ► 603 Z Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
S-11-13 ' m nn r Somm Wllrll 6 -70'
Total X 5 7 06
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 NO. WARRANT NO.
ALLOWED 20
Vi��� -,� IN SUM OF $
770 3r' A,, S .
(krmej , -T/V �403Z
$X65700
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
3 330 Z,2� b0 657 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
�^ 2"=20 l
�2 I i�gatu
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund