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HomeMy WebLinkAbout224281 09/23/2013 CITY OF CARMEL, INDIANA VENDOR: 353845 Page 1 of 1 ONE CIVIC SQUARE - CONSTRUCTION MGT INC CARMEL, INDIANA 4602 13518 MYRTLE LANE CHECK AMOUNT: $41,639.40 FISHERS IN 46038 CHECK NUMBER: 224281 y<'roe co.. CHECK DATE: 9/23/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 106 5023990 29569 1587 41, 639 . 40 FOUNDERS PARK SPORTS TM *AIA Document G702 _ 1992 Application and Certificate for Payment TO OWNER:Carmel/Clay-Board of Parks& Recreation PROJECT: Founders Park Sports Field APPLICATION NO 4 . Distribution to: 14111:E,11,16th Street Improvements Project pERIOD'TO 8/29/13 OWNER F1 Camel, IN 46032 CONTRACT FOR: General Construction ARCHITECT ❑ FROM CONTRACTOR:Myers Construction Mgmt., Inc. VIA ARCHITECT: The Schneider Corporation CONTRACT DATE: 3/18/13 CONTRACTOR ❑ 13518 Myrtle Lane 8901 Otis Avenue Fishers, IN 46038 Indianapolis, IN 46216 PROJECT NOS: / / FIELD ❑ Invoice#1587 Job#506 OTHER ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information 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 Contractor for Work for AIA Document G703TM,Continuation Sheet,is attached. which pr vi ertificates for Payment were issued and payments received from the Owner, and 1.ORIGINAL CONTRACT SUM ................... .....:...................... $ 417,000.00 that curre paymen hown herein is now d e. 2. NET CHANGE BY CHANGE ORDERS .. ................ $ (18,004.00) CON R: Mye s tion gemenf,'Inc 3.CONTRACT SUM TO DATE(Line 1'f 2) ...... .............................. $ 398,996.00 By: Date: 4.TOTAL COMPLETED&STORED TO-DATE(Column G on G703) ...... $ 398,996.00 State of: v1 rla__ 5.RETAINAGE: County of: Han[+on — — a. 10 %of Completed Work Subscribed and sworn to before �ST T, SANDRA K. PAYERS (Columns D+..E on G703) $ 39,899.60 me this Zq'I►� day �` o Notary Public,State of Indiana A htsl" Zo(a- y Hamilton County o m Commission u 607058 b. 10 /o of Stored Material (Column F on G703) $ 0.00 Notary Public: / t• ~, My August 23,Commission My commission expires: Total Retainage(Lines 5a+5b,or Total in Column I of G703)...... $ 39,899.60 6.TOTAL EARNED LESS RETAINAGE .................................... $ 359,096.40 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 minus Line 5 Total) In accordance with the Contract Documents,based on on-site observations and the data comprising 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT ...................... $ 317,457.00 this application,the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in (Line 6from prior Certificate) accordance with the Contract Documents, and the Contractor is entitled to payment of the 8.CURRENT PAYMENT DUE ................... ................... $ 41 639.40 AMOUNT CERTIFIED. 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED ................. .. ..... $ r�`� I'Ky .... (Line 3 minus Line 6) $ 39,899.60 (Attach explanation if amount certified d�ffersfrom.theamount applied. /nitial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITEC Total changes approved m prevwus months by Owner $ 0.00 $ (18,004.00) By: � Date: �A/Zoes Total approved this month $ 0.00 $ 0.00 This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractor TOTAL $ 0.00 $ (18;004.00) named herein Issuancepayment and acceptance of payment are without prejudice to any rights of Change Order $ (18,004.00) the Owner or 66:ntractor under this Contract. ET CHANGES b CAUTION:You should sign an original AM Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G702TM—1992.Copyright @ 1953, 1963, 1965, 1971,1978,1983 and 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 AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. 010711AGD44 I 1i 111e,A I A D®CU ntG702 ® 1992 Instructions Application and Certificate for-Pay►nent GENERAL INFORMATION '1 Purpose and Related Documents. AIA Document-G.702 TM-1992,Application and Certificate for Payment, is to be used in conjunction with AIA Document G703T"';°Cow tinuation Sheet. These documents are designed to be used on a' Project where a Contractor has a direct Agreernejt;vvitli th'e.Owner. Procedures for their use are covered in AIA 75 Document A201 TM,General Conditions of t@ Contraci-for Construction. Use of Current Documents. Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions.This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIAierebygrants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to:reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement(EULA). To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects' legal counsel,copyright @aia.org. COMPLETING G702 After the Contractor has completed AIA Document G703,Continuation Sheet, summary information should be transferred to AIA Document G702,Application and Certificate for Payment. The Contractor should sign G702,have it notarized,and submit it,together with G703,to the Architect. The Architect should review G702 and G703 and, if they are acceptable,complete the Architect's Certificate for Payment on G702. The Architect—may certify a different amount than that applied for,pursuant to Sections 9.5 and 9.6 of A201. The Architect should then initial all figures on G702 and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G702 and G703 should be forwarded to the Owner. MAKING PAYMENT The Owner should make payment directly to the Contractor based on the amount certified by the Architect on AIA Document G702,Application and Certificate for Payment. The completed form contains the name and address of the Contractor. Payment should not be made to any other party unless specifically indicated on G702. EXECUTING THE DOCUMENT Persons executing the document should indicate the capacity in which they are acting(i.e.,president,secretary, partner,etc.)and the authority under which they are executing the document. Where appropriate,a copy of the resolution authorizing the individual to act on behalf of the firm or entity should be attached. AIA Document G702 TM—1992.Copyright©1953,1963,1965,1971,1978,1983 and 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 AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. 010711ACD44 Myers Construction Management, Inc. Page: 2 AIA Continuation Sheet Application No.: 4 Application Date: 8/29/13 Period To: 8/29/13 Job: Founders Park Sports Field Improvements Project A B C D E F G H I Item Scheduled Work Completed Stored Total Comp. Percent Balance No. Description of Work Value Previous This Period Material & Stored Complete to Finish Retainage 1000 General Conditions 1 Supervision 11,000.00 10,000.00 1,000.00 0.00 11,000.00 100% 0.00 1,100.00 2 Performance& Payment Bond 8,000.00 8,000.00 0.00 0.00 8,000.00 100% 0.00 800.00 3 Builders Risk Insurance 1,020.00 1,020.00 0.00 0.00 1,020.00 100% 0.00 102.00 4 Maintenance Bond 1,500.00 0.00 1,500.00 0.00 1,500.00 100% 0.00 150.00 5 Misc. General Conditions 2,170.00 1,700.00 470.00 0.00 2,170.00 100% 0.00 217.00 6 Contingency Allowance 18,004.00 0.00 18,004.00 0.00 18,004.00 100% 0.00 1,800.40 6.1 WISCO well installation 19,375.00 0.00 19,375.00 0.00 19,375.00 100% 0.00 1,937.50 6.2 Credit waterline/meter permit (3,500.00) 0.00 (3,500.00) 0.00 (3,500.00) 100% 0.00 -350.00 6.3 Credit booster pump slab (400.00) 0.00 (400.00) 0.00 (400.00) 100% 0.00 -40.00 6.4 Credit Prairie seeding (12,000.00) 0.00 (12,000.00) 0.00 (12,000.00) 100% 0.00 -1,200.00 6.5 Add plantings at Footwash 2,021.00 0.00 2,021.00 0.00 2,021.00 100% 0.00 202.10 6.6 Weed Control 1,500.00 0.00 1,500.00 0.00 1,500.00 100% 0.00 150.00 2000 Site Work 1 Surveying 6,000.00 6,000.00 0.00 0.00 6,000.00 100% 0.00 600.00 2 Excavation 135,000.00 135,000.00 0.00 0.00 135,000.00 100% 0.00 13,500.00 3 Erosion Control 6,200.00 6,200.00 0.00 0.00 6,200.00 100% 0.00 620.00 4 Storm Sewer 58,000.00 58,000.00 0.00 0.00 58,000.00 100% 0.00 5,800.00 5 Sanitary Sewer 11,000.00 11,000.00 0.00 0.00 11,000.00 100% 0.00 1,100.00 6 Water Line& Meter Pit 5,000.00 0.00 5,000.00 0.00 5,000.00 100% 0.00 500.00 7 Concrete Sidewalks-Material 1,710.00 1,710.00 0.00 0.00 1,710.00 100% 0.00 171.00 8 Concrete Sidewalks- Labor 3,000.00 3,000.00 0.00 0.00 3,000.00 100% 0.00 300.00 9 Concrete Curbs 1,000.00 1,000.00 0.00 0.00 1,000.00 100% 0.00 100.00 10 Sundial Structures-Material 45,000.00 45,000.00 0.00 0.00 45,000.00 100% 0.00 4,500.00 11 Sundial Structures- Labor 6,800.00 6,800.00 0.00 0.00 6,800.00 100% 0.00 680.00 12 Foot Shower-Material 4,000.00 4,000.00 0.00 0.00 4,000.00 100% 0.00 400.00 13 Foot Shower-Labor 4,000.00 4,000.00 0.00 0.00 4,000.00 100% 0.00 400.00 14 Bench-Material 1,600.00 1,600.00 0.00 0.00 1,600.00 100% 0.00 160.00 15 Bench- Labor 300.00 300.00 0.00 0.00 300.00 100% 0.00 30.00 16 Landscaping 400.00 0.00 400.00 0.00 400.00 100% 0.00 40.00 17 Sports Field Seeding 15,300.00 0.00 15,300.00 0.00 15,300.00 100% 0.00 1,530 00 18 Prairie Seeding 12,000.00 0.00 12,000.00 0.00 12,000.00 100% 0.00 1,200.00 19 Irrigation 43,600.00 40,000.00 3,600.00 0.00 43,600.00 100% 0.00 4,360.00 3000 Concrete 1 Concrete Footings- Labor 3,000.00 3,000.00 0.00 0.00 3,000.00 100% 0.00 300.00 2 Concrete Footings-Material 3,000.00 3,000.00 0.00 0.00 3,000.00 100% 0.00 300.00 3 Rebar-Material 800.00 800.00 0.00 0.00 800.00 100% 0.00 80.00 Continued Next Page Myers Construction Management, Inc. Page: 3 AIA Continuation Sheet Application No.: 4 Application Date: 8/29/13 Period To: 8/29/13 Job: Founders Park Sports Field Improvements Project A B C D E F G H I Item Scheduled Work Completed Stored Total Comp. Percent Balance No. Description of Work Value Previous This Period Material & Stored Complete to Finish Retainage 7000 Thermal & Moisture 1 Caulking 1,600.00 1,600.00 0.00 0.00 1,600.00 100% 0.00 160.00 C.O.1 Credit Contingency (18,004.00) 0.00 (18,004.00) 0.00 (18,004.00) 100% 0.00 -1,800.40 Total 398,996.00 352,730.00 46,266.00 0.00 398,996.00 100% 0.00 39,899.60 AFFIDAVIT AND WAIVER OF LIEN PARTIAL State of Indiana County of Hamilton, SS: Donald R. Myers being duly sworn states that he is the President of Myers Construction Management, Inc. having contracted with Carmel/Clay Board of Parks and Recreation to furnish certain materials and/or General Construction for a project known as Founders Park Sports Field Improvements Projects located in Carmel, IN and does further state on behalf of the aforementioned contractor/supplier: That there is due from the owner the sum of �ot'fV-osle�Gtocesart srx huytdl'ed i�1rr�l-yline and "//oO Dollars $ q1) (0�q. 40 ( ) receipt of which is hereby acknowledged; or (✓jthe payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned. THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all lien or claim whatsoever on the above-described property and improvements thereon on account of labor or material or both, furnished by the undersigned thereto, subject to limitations or conditions expressed herein, if any; 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. By Title: President WITNESS MY HAND AND NOTORIAL SEAL, This Zq day of E-1 uS+ 2013. My Commission Expires: 8-23-17 Printed: Sandra K. Myers County of Residence: Hamilton SANDRA K. MYERS o y e Notary Public_, State of Indiana Hamilton County t Commission At 607058 My Commission Expires ,, August 23, 2017 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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 Purchase Order No. 353845 Myers Construction Mgmt., Inc. Date Due 13518 Myrtle Lane Fishers, IN 46038 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO# Amount 8/29/13 1587 Founders Pk Sports field improvement 29569 $ 41,639.40 Pay app#4 Total $ 41,639,40 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 353845 Myers Construction Mgmt., Inc. 13518 Myrtle Lane Fishers, IN 46038 In Sum of$ $ 41,639.40 ON ACCOUNT OF APPROPRIATION FOR 106 Park Impact Fee Fund PO#or INVOICE NO. CCT#/TITLI AMOUNT Board Members Dept# 29569 1587 5023990 $ 41,639.40 1 hereby certify that the attached invoice(s), 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 19-Sep 2013 Signature $ 41,639.40 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund I I I