Loading...
HomeMy WebLinkAbout228103 1/14/2014 CITY OF CARMEL, INDIANA VENDOR: 358582 Page 1 of 1 ONE CIVIC SQUARE PATTERSON HORTH INC CARMEL, INDIANA 46032 5745 PROGRESS DRIVE CHECK AMOUNT: $280,240.50 �a. INDIANAPOLIS IN 46241 .oCHECK NUMBER: 228103 CHECK DATE: 1/14/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 106 R5023990 36195 PAY APP #2 280, 240 . 50 FOUNDERS PARK PAVILLI Purchase FVVADM p*kK D'so.iption P.O.# 5&0155- P r F &13 *AIA ® G.L.#JQ(6— 5D23950 TM I ud:�et ®cueht 6702 m 1992 Line Descr1�1�ypgA� Purchaser Date Application and Certificate for Payment Approval Datew TO OWNER: Carmel Clay Board of Parks and IPROJECT: Founders Park Pavillion Project APPLICATION NO:002 Distribution to: Recreation 1 Dell Patkkvay PERIOD TO: December 31,2013 OWNER: 1411 E. 116th St. Carmel, I'IN V 4 46032 Carmel,IN 46032 CONTRACT FOR:General Construction ARCHITECT: FROM VIA CONTRACT DATE: CONTRACTOR: CONTRACTOR: Patterson-Horth,Inc. ARCHITECT: PROJECT NOS: /21324/ 5745 Progress RoadFIELD: Indianapolis,IN 46241 OTHER: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AiA Document G703,is attached. Certificates for Pa}mtent were issued and payments received from the Owner, and that current 1. ORIGINAL CONTRACT SUM ......................................................................... S 1,160,000.00 payment shown herein is now due 1. NET CHANGE BY CHANGE ORDERS......................................................... S 172,737.37 CONTRAC 3. CONTRACT SUM TO DATE(Line 1 f 2)..................................................... S 1,332,737.37 By: Date: Dec. 31 , 2013 4. TOTAL COMPLETED & STORED TO DATE(Column G on G703)........... S 452,120.00 State o :111dia-na 5. RETAINAGE: County of:Marion a. 5 %of Completed Work Subscribed an sworn to before =PublicSeal fey (Column D+E on G703) S 22.606.00 me this3)5+ day of�.J,bI! ate of Indianab. 0 %of Stored Material untyes 0 6/0 312 01 8 (Column F on G703) $ 0.00 Notary Public `/ Total Retainage Lines 5a+5b or Total in Column I of G703) S 22,606.00 My Commission expires: 6. TOTAL EARNED LESS RETAINAGE.............................I.............................. S 429,514.00 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 ............................... S 149.273.50 this application; the Architect certifies to the Owner that to the best of the Architect's knowledge, (Line 6 from prior Certificate) information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT 8. CURRENT PAYMENT DUE.......................................................................... I S 280.240.5 CERTIFIED. 9. BALANCE TO FINISH, INCLUDING RETAINAGE AMOUNT CERTIFIED .................................................................................. S 250,240.50 (Line 3 less Line 6) $ 903,223,37 (Attach explanation if amount cergfted dii et:c ft•oni the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) RANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Total changes approved in previous months by Owner $ 0.00S 0.0 By: Date: otal approved this Month $ 172.737.3 S 0.0 TOTALS $ 172,737.3 S 0.0 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of ET CHANGES by Chane Order $ 172,737.3 the Owner or Contractor under this Contract. AIA Document G702T —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.This document was produced by AIA software at 10:42:37 on 12/24/2013 under Order No.1857109399_1 which expires on 07/12/2014,and is not for resale. User Notes: (1768388440) O ® TM Document G703 ® 1992 Continuation Sheet AIA Document,G7021m-1992,Application and Certification for Payment,or G736T"-2009, Project Application and Project Certificate for Pa APPLICATION N0:002 ProJ Pp J Payment,Construction Manager as Adviser Edition, containing Contractor's signed certification is attached. APPLICATION DATE: 12/31/2013 In tabulations below,amounts are in US dollars. PERIOD TO: 12/31/2013 Use Column 1 on Contracts where variable retainage for lite items may apply. ARCHITECT'S PROJECT NO: A B C D I E F G H I WORK COMPLETED TOTAL MATERIALS ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY COMPLETED % BALANCE TO RETAINAGE NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (G_C) (D+E) (NOT IN D OR E) (D+E E) (C-G) RATE) 1 P&P Bond 15,584.00 15,584.00 0.00 0.00 15,584.00 100.00% 0.00 779.20 2 Supervision 23,068.00 3,124.00 3,124.00 0.00 6,248.00 27.09% 16,820.00 312.40 Misc.General 3 Conditions 2,675.00 0.00 890.00 0.00 890.00 33.27% 1,785.00 44.50 4 Earthwork 127,974.00 89,157.001 13,248.00 0.00 102,405.00 80.02% 25,569.00 5,120.25 5 Paving 6,993.00 0.00 0.00 0.00 '0.00 0.00% 6,993.00 0.00 6 Landscaping 8,855.00! 0.00 0.00 0.00 0.00 0.00% 8,855.00 0.00 7 Concrete 114,676.00 34,068.00 26,807.00 0.00 60,875.00 53.08% 53,801.00 3,043.75 8 Masonry 102,000.00 0.00 45,087.00 0.00 45.087.00 44.20% 56,913.00 2,254.35 9 Structural Steel 33,800.00, 0.00 33,800.00 0.00 33,800.00 100.00% 0.00 1,690.00 10 Rough Carpentry 142,237.00 0.00 107,890.00 0.00 107.890.00 75.85% 34,347.00 5,394.50 11 Roofing 43,850.00 0.00 0.00 0.00 ,0.00 0.00% 43,850.00 0.00 Doors,Frames, 12 Hardware 14,133.00 0.00 10,150.00 0.00 10,150.00 71.82% 3,983.00 507.50 13 Glass&Glazing 43,837.00 0.00 0.001 0.00 0.00 0.00%1 43,837.00 0.00 Framing, Drywall, 14 Ceilings 132,100.00 0.00 41,087.00 0.00 41,087.00 31.10% 91,013.00 2,054.35 15 Flooring 26,442.00 . 0.00 0.00 0.00 0.00 0.00% 26,442.00 0.00 16 Painting 11,700.00 0.001 0.00 0.00 0.00 0.00% 11,700.00 0.00 17 Misc Specialties 36,076.00 0.00 0.00 0.00 0.00 0.00% 36,076.00 0.00 18 HVAC&Plumbing 103,000.00 15,197.00 -0.001 0.00 15,197.00 14.75% 87,803.00 759.85 19 Electrical. 121,000.00 0.00 12,907.00 0.00 12.907.00 10.67% 108,093.00 645.35 20 Allowance 50,000.00 0.00 0.001 0001 0.00% 50,000.00 0.00 AIA Document G70311-1992.Copyright©1963,1965.1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA°Document isprotected by U.S. Copyright Law and International Treaties.Unauthorized reproduction or distribution of this A10 Document,or any portion of it,may result in severe civil and criminal penalties,and will ba prosecuted to ) the maximum extent possible under the law.This document was produced by AlA software at 10:30:03 on 12/24/2013 under Order No.1857109399 1 which expires on 07/12/2014,and is not for resale. ` User Notes: - r A B C D E F G H I WORK CON4PLETED TOTAL i j MATERIALS € €ITEM DESCRIPTION OF SCHEDULED FROMPRESENTLY COMPLETED BALANCE TO RETAINAGE NO. WORK VALUE PREVIOUS I AND STORED TO % FINISH (IF VARIABLE 1 THIS PERIOD STORED (G_C) APPLICATION ! DATE (C-G) RATE) s (D E-} ; (NOT IN D OR E) (D-E-LF) CO#1-Scope I 21 Changes 92,737.37 0.00 0.00 0.00 0.00 0.00% 92,737.37 0.00 CO#I-Winter Conditions 22 Allowance 55,000.00': 0.001 0.00 0.00 0.00 0.00% 55.000.00 0.00 CO#1-Additional I € 23 STM Allowance 25,000.0011 0.00, 0.00 0.00 0.00 0.00% 25,000.00 0.00 0.00 0.001 0.00 0.001 0.00 0.00%I 0.00 0.001 0.00 0.001 0.00 0.001 0.001 0.00% 0.00 0.00' 0.00 0.001 0.00 0.001 0.00 0.00% 0.00 0.00 0.00 0.001, 0.001 0.001 0.00 0.00% 0.00 0.00 GRAND TOTAL $1,332,737.37 $157,130.001 S294.990.0015O.001 $452,120.00 33.92% 5880,617.37 522,606.00 AIA Document G703r"-1992.Copyright Q1963.1965.1966.1967.1970,1978.1983 and 1992 by The American InsStute of Architects.AO rights reserved.bVAfZNING:This AIA''Document is protected by U.S. copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA±'Document,or any portion of it.may result in sevore civil and criminal penalties,and will be prosecuted to 2 the maximum extent possible under the law.This document was produced by AIA software at 10:30:03 on 12124/2013 under Order No.1857109399_1 which expires on 07/1212014,and is not for resale. User Notes: (861557291) Patterson - Horth Inc. 5745 Progress Drive INVOICE Indpls., IN 46241 Invoice Number: 2972 Invoice Date: Dec 24,2013 Page: 1 Voice: (317)243-6104 Fax: (317)243-6398 Bi�1T'Q,`+7'.-;',,-tea �C 3' � ..11� � :��s i zea,>� F ,�hlf" �Q�,. 1 ,i. •y 4 hs..:,,. � „r.�� �t�—s.:.�z �R N�$^#�5 -1�;t Carmel Clay Board of Parks& Rec. Carmel Clay Board of Parks&Rec. 1411 E 116th St. 1411 E 116th St. Carmel, IN 46032 Carmel, IN 46032 f I ! ' I 1 Customer%IDSA" . �usEomer PD 4 a n�K� '„ `= 3 Paymen(s Te Carmel Ciay _ Net 30 Days -- ,..._.� r IGT ' ,Courier— 1/23/14` r_T._f--f-_,- Its l —._..`'T •.. j t �+,.f, .��x .„>v e .0 t u r t o'..,''_'""_' .s.�..:e y -i,.: :i Quantity s I#etrt Descrlptionx �}�... : , #.t_.;xUn3t Brice t., mounk Progress Billing#2 Founders Park 294,990.00 Retainage -14,749.50 ' i i i I i i 1 � t f lu ! I I Subtotal 280,240.50 Sales Tax — Total Invoice Amount 280,240.50 Check/Credit Memo No: .Payment/Credit Applied 111...,..�". ,+ .,? IS .x.. 1 c h,F 1 PA" "I'f.R S 0 N 1-10 R T H GENERAL Cos.ru,�Crues OWNER AFFIDAVIT AND WAIVER AND RELEASE OF LIEN AND CLAIMS t The undersigned, being duly sworn upon his oath,states that he is the principal owner,officer, or authorized agent of Patterson-Horth, Inc. ("Contractor"),and is duly authorized to enter into this agreement and make these affirmations on behalf of the Contractor,which is contracted with Carmel Clay Board of Parks and Recreation to furnish materials, labor or services for a project known as Founders Park Pavillion Project (hereinafter"Project"), owned by Carmel Clay Board of Parks and Recreation and does hereby further state that the sum of $ 280,240.50 is due Contractor,the payment of which is made as consideration for this Affidavit and Waiver and Release of Liens and Claims and constitutes full and complete satisfaction of all sums owing to Contractor(less retainage)up to December 31, 2013 (date of application). Therefore,as to the following entities: Patterson-Horth, Inc. Fidelity and Deposit Company of Maryland and all other entities have an interest in this project,the undersigned as duly authorized agent for Contractor hereby waives and releases any and all claims,Verified Statement of Claims and Mechanic's Liens,and further waives and releases any and all other liens or claims or rights to liens or claims whatsoever on the above-described property,on account of labor, materials or services furnished by Contractor. Contractor further certifies that all funds received from this project have been applied for the payment for labor,material and services furnished to this project by employees,subcontractors and material suppliers and that no other party has any lien or claim on account of any work performed or material furnished for said Project,and within the scope of this Affidavit and Waiver up to December 31,2013 (date of application). By: Printed: Michael K. Patterson Title: President STATE OF INDIANA ) SS: COUNTY OF MARION ) The foregoing, before me,a notary public, personally appeared Michael K. Patterson as President ,duly authorized officer or agent of Patterson-Horth, Inc. who having been duly sworn, acknowledged the execution of the foregoing Affidavit and Waiver and Release of Liens and Claims,for and on behalf of said corporation and stated that the representations therein contained are true. WITNESS my hand and notary seal this 31st day of December 2 13 Signed: x�4 - Printed: Kristina iffey Notary Public My Commission Expires: My County of Residence is: Contractor further certifies that upon receipt of payment listed above, the unpaid balance of materials,labor or services for the project is $ 903,223.37 Kristina RiHey Notary Public Seal State of Indiana • Hendricks County My Commission Expires 00/03/201 a 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. 358582 Patterson-Horth, Inc. Date Due 5745 Progress Road Indianapolis, IN 46241 I Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO# Amount 12/31/13 Pay App#2, Founders Park Pavillion project 36195 $ 280,240.50 Total $ 280,240.50 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 5-11-10-1.6 120 Clerk-Treasurer Voucher No. Warrant No. Allowed 20 358582 Patterson-Horth, Inc. 5745 Progress Road Indianapolis, IN 46241 In Sum of$ $280,240.50 4 ON ACCOUNT OF APPROPRIATION FOR 106 Park Impact Fee PO#or INVOICE NO. kCCT#ITITLI AMOUNT Board Members Dept# 36195 Pay App#2 5023990 $280,240.50 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 9-Jan 2014 $280,240.50 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund