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227824 1/8/2014
as°•-..+�,4f CITY OF CARMEL, INDIANA VENDOR: 367103 Page 1 of 1 ONE CIVIC SQUARE RENASCENT INC CHECK AMOUNT: $19,793.33 CARMEL, INDIANA 46032 935 W TROY AVE ' ? INDIANAPOLIS IN 46225 CHECK NUMBER: 227824 CHECK DATE: 1/8/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 211 R4462300 25266 4 19, 793 . 33 NASH BLDG UTILITY REL CONSTRUCTION PROJECT INVOICE DATE: December 9, 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.: 4 TOTAL EARNINGS TO DATE: $ 179,769.59 MINUS 10% RETAINAGE: $ 17,976.96 TOTAL EARNED MINUS RETAINAGE: $ 161,792.63 MINUS PREVIOUS PAYMENTS: $ 1411999.30 TOTAL AMOUNT DUE: $ 19,793.33 Tiffa o0 Construction Inspector s ,_ City of Carmel APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE 1 OF 2 TO OWNER: PROJECT: Project 13-03 APPLICATION NO: 298-AP4 Distribution to: The City of Carmel Nash Building Utility Relocation X OWNER One Civic Square PO 25266 ARCHITECT Carmel,IN 46032 PERIOD TO: 11/19/2013 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, 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 Doyuments,that all amounts have been paid by the Contractor for Work for which previous Qertificates for Payment were issued and payments received from the Owner,and that uVd'hVpW pentlshown herein is now due. 1. ORIGINAL CONTRACT SUM $ 157,777.00 2. Net change by Change Orders $ 21,992.59 CONTRACTOR: _ 0 - Nor SIR, ` 3. CONTRACT SUM TO DATE(Line 1 +2) $ 179,769.59 "o;;;p,�,:' aryPUb�4HC.N 4 4. TOTAL COMPLETED&STORED TO $ 179,769.59 My S��Sta DATE (Column G on G703) By: ��/17 to A4 t' S 5. RETAINAGE: p/ %a. 10 %of Completed Work $ 17,976.96 State of: INDIANA County of: N 31812 (Column D+E on G703) Subscribed and swo n before me this / 9 day of b. 0 %of Stored Material $ 0.00 Notary Public: . Gt• �/L C l / (Column F on G703) My Commission expires: Total Retainage(Lines 5a+5b or " Total in Column I of G703) $ 17,976.96 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 161,792.63 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) $ 141,999.30 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE $ 19,793.33 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE 17,976.96 3� (Line 3 less Line 6) AMOUNT CERTIFIED. . . . . .. . . . .$ f 793. (Attach explanation if amount certified differs from the amount applied. Initial all figures on this Total changes approved Application and on the Continuation Sheet that are changed to conform with the amount certified.) in previous months by Owner $0.00 $0.00 ARCHITECT: Total approved this Month 521,992.59 $0.00 By: Date: TOTALS $21,992.59 $0.00 This Ce Cate is no egotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein.Issuance,payment and acceptance of payment are without NL I UHANIiLJ oy uhange Urcler $21,992.59 preluaice to any ngnts or the Uwner or contractor under tins Uontract. 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 SHEET AIA DOCUMENT G703 PAGE 2 OF 2 APPLICATION NO: 298-AP4 Contractor's signed certification is attached. APPLICATION DATE: l 1/19/2013 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: I 1/19/2013 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: . Nash Building Utility Relocation; PO 925266 A B C D E F G H I Cost DESCRIPTION OF WORK 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 69,000.00 0.00 69,000.00 100% 0.00 6,900.00 3800 Water 50,000.00 50,000.00 0.00 50,000.00 100% 0.00 5,000.00 4000 Jersey Barriers 14,000.00 14,000.00 0.00 14,000.00 100% 0.00 1,400.00 1500 Demo Existing Storm and Water 6.000.00 6,000.00 0.00 6,000.00 100% 0.00 600.00 4000 New Sidewalk and curb 12,700.00 12.700.00 0.00 12,700.00 100% 0.00 1,270.00 1400 Erosion Control 4,077.00 4,077.00 0.00 4,077.00 100% 0.00 407.70 9250 Mob and Demob 2.000.00 2,000.00 0.00 2,000.00 100% 0.00 200.00 Change Order#I 21,992.59 0.00 21,992.59 21,992.59 100% 0.00 2,199.26 GRAND TOTALS 179,769.59 157,777.00 21,992.59 0.00 179,769.59 100.00% 0.00 1 17,976.96 AIA DOCUMENT G703-CONTINUATION SHEET FOR G702 1992 EDITION AIA ©1992 G703-1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,N.W.WASHINGTON,D.C.20006-5292 i RECEIPT, WAIVER, AND RELEASE OF LIEN RIGHTS Partial5x] Final F] 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: 11/19/2013 Application 298-AP4 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: $19,793.33 Signature: 44 Name (printed) Linda Campbell Title: President Date: 11/19/2013 WITNESS by hand and official seal, this Cl Day of q)x- -btu 20 Notary Public: Name (printed): Sarah C. Hall _ Nota,,,p~`��fr; HqLt County of Residence: Marion =,NpNp ,,•' ublic,Stat Commission expires: 3.8.19 MyComnrissi nFAC State of _3181201g 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: December 9, 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.: 5 TOTAL. EARNINGS TO DATE: $ 179,769.59 RETAINAGE TO BE RELEASED: $ 17,976.96 MINUS PREVIOUS PAYMENTS: $ 161,792.63 TOTAL AMOUNT DUE: $ 17,976.96 T 1 ffa nv y*t oon-e Construction Inspector City of Carmel n RENASCENT � � 935 W.Troy Ave.•Indianapolis,IN 46225 Office 317.783.1500•Fax 317.783.4860 www.Renascentlnc.com November 191h, 2013 The City of Carmel One Civic Square Carmel, IN 46032 Attn: Ms. Tiffany Boone RE: Request for Retainage Dear Ms. Boone: Renascent, Inc. has completed its contract for the Nash Building Utility Relocation. Please accept this request to release our final retainage in the amount of $17,976.96. Thank you. Sincerely, Linda Campbell President APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE 1 OF 2 TO OWNER: PROJECT: Project 13-03 APPLICATION NO: 298-AP-Retainage Distribution to: The City of Carmel Nash Building Utility Relocation X OWNER One Civic Square PO 25266 ARCHITECT Carmel,IN 46032 PERIOD TO: 11/19/2013 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, 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 C rt+ftcates for Payment were issued and payments received from the Owner,and that rrgil gaj;i'hant hown herein is now due. 1. ORIGINAL CONTRACT SUM 157,777.00 st,.TEo''••, 2. Net change by Change Orders $ 21,992.59 CONTRACTOR: td r S 3. CONTRACT SUM TO DATE(Line 1 +2) $ 179,769.59 Notary Public C `;, do :N, ,• ubl c� HAS[ � 4. TOTAL COMPLETED&STORED TO $ 179,769.59 DATE (Column G on G703) By: My co" Z 0(Edi 5. RETAINAGE: ft arpir a. 10 %of Completed Work $ 0.00 State of: INDIANA Cou�tyof:(Column D+E on G703) Subscribed and swor before me this /G, dayN �t� b. 0 %of Stored Material $ 0.00 Notary Public: (— (Column (Column F on G703) My Commission expires: Total Retainage(Lines 5a+5b or 3, 911 Total in Column I of G703) $ 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 179,769.59 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) $ 161,792.63 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE $ 17,976.96 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE 0.00 // O (Line 3 less Line 6) AMOUNT CERTIFIED. . . .... . . ..$ 17 7lp ! (Attach explanation if"amount certified differs from the amount applied. Initial all figures on this Total changes approved Application and on the Continuation Sheet that are changed to conform with the amount certified.) in previous months by Owner $0.00 $0.00 ARCHITECT: Total approved this Month $21,992.59 $0.00 By: Date: t 1AS-11 3 TOTALS $21,992.59 $0.00 This Certificate is not neg cable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance,payment and acceptance of payment are without Nr I UHANIiI:J oy unange Uraer $21,992.59 prejualce to any ngnts or the Uwner or l;ontractor under tins Uontract. 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 SHEET AIA DOCUMENT G703 PAGE 2 OF 2 APPLICATION NO: 298-AP-Retainage Contractor's signed certification is attached. APPLICATION DATE: 11/19/201 3 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 1 1/19/2013 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: . Nash Building Utility Relocation; 110 925266 A B C D E F G H I Cost DESCRIPTION OF WORK 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 69,000.00 0.00 69,000.00 100% 0.00 0.00 3800 Water 50,000.00 50,000.00 0.00 50,000.00 100% 0.00 0.00 400-0---.Jersey Barriers 14,000.00 14,000.00 0.00 14,000.00 100% 0.00 0.00 1500 Demo Existing Storm and Water 6.000.00 6,000.00 0.00 6,000.00 100% 0.00 0.00 4000 New Sidewalk and curb 12,700.00 12.700.00 0.00 12,700.00 100% 0.00 0.00 1400 Erosion Control 4,077.00 4,077.00 0.00 4,077.00 100% 0.00 0.00 9250 Mob and Demob 2.000.00 2,000.00 0.00 2,000.00 100% 0.00 0.00 Change Order 41 21,992.59 21,992.59 0.00 21,992.59 I00%_______0.00 0.00 GRAND TOTALS 179,769.59 179,769.59 0.00 0.00 179,769.59 100.00% 0.00 1 0.00 AIA DOCUMENT G703-CONTINUATION SHEET FOR G702 1992 EDITION-AIA-0 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 FinalF 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: 11/19/2013 Application 298-AP- 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: $17,976.96 Signature: gj�_& QJ_V 66��4 Name (printed) Linda Campbell Title: President Date: 11/19/2013 WITNESS by hand and official seal, this Day of GVIRr�m 20�2L Notary Public: "sTATF'. Name (printed): Sarah C. Hall County of Residence: Marion `=,%a.;.,.,..,/'?,. Not, SqR 444 Commission expires: 3-8-19 Rik C, / Ub10,t"ofn y sson l d�a�a c� FXAireB.?181?01 9 Renascent,Inc.dba Campbell Land Development dba Construction a 935 W.Troy Ave. Indianapolis,IN 46225 317.783.1500 Fax 317.293.7108 AccountingCa)callCW.com 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 12/9/2013 4 Nash Building Utlity Relocation $ 19,793.33 Total $ 19,793.33 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 NC WARRANT NO. Renascent Inc ALLOWED 20 935 West Troy Avenue IN SUM OF$ Indianapolis, IN 46032 $ 19,793.33 ON ACCOUNT OF APPROPRIATION FOR Board Members Po#or INVOICE NO. ACCT#/TITL AMOUNT DEPT# I hereby certify that the attached invoice(s), 25266 4 211-R4462300 $ 19,793.33 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 ,r 1/21/1929 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund