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Home My WebLink About228591 1/28/2014 CITY OF CARMEL, INDIANA VENDOR: 367514 Page 1 of 1 ONE CIVIC SQUARE JBM CONTRACTORS CORP .� CARMEL, INDIANA 46032 5299 W OLD 106TH ST CHECK AMOUNT: $9,162.80 ZIONSVILLE IN 46077 CHECK NUMBER: 228591 CHECK DATE: 1/28/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 652 5023990 20-13-01 200 . 00 OTHER EXPENSES 652 5023990 RETAINAGE 8, 962 . 80 OTHER EXPENSES Sequential no,: 20-13-01 CONI TPACTOPS COPP. BM Invoice Job Name: Carmel Utilities Job Number:13-18 Address 30 W.Maint Street-Carmel,IN Date:11/13/2013 Bill To: John Duffy Construction Work Order(CWO)No.: Customer Field Work Order(FWO)No,: Description: Sand and restain hand rail in North stairwell $200.00 Labor: Reg OT Reg Trade: Employee Name: Mo Tu We Th Fr Sa Hrs Hrs Rate OT Rate Amount Total Labor! 0 jSub(s),Material andior Equipment: J Amount ($) Price/Unit IDescription: Oty. Price Vision Painting 400.00 J Total Sub(s),!J�aterinl and'ot Equipment: 406 Sub-total 400 Approved by: Michael Stuerenberg Overhead&Profit 0 *Sub-total 400 Date: 11113/2013 Bond&Insurance 0 Total 206' Notes: MAKE ALL CHECKS PAYABLE TO JBM CONTRACTORS CORP-TOTAL DUE IN 15 DAYS OVERDUE ACCOUNTS SUBJECT TO A 1%A MONTH SERVICE CHARGE rounded to the nearest dollar Prescribed by State Board of Accounts Form No.301-S(Rev.1997) ACCOUNTS PAYABLE VOUCHER TO ADDRESS Invoice Date Invoice Number Item Amount I 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 Mo. Day Yr. Signature Title 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. Mo. Day Yr. Officer Title Voucher No. Warrant No. ACCOUNTS PAYABLE , DETAILED ACCOUNTS MUNICIPAL WASTEWATER UTILITY ACCT. CARMEL, INDIANA No. Favor Of 'Ta m CoN t,cR C-toes s2�q w 010( too 5-' i 2 ' 1 Total Amount of Voucher $ Deductions O O 0 0 1 . 30 3.0.0 Amount of Warrant $ Month of Yr Acct. VOUCHER RECORD No. Collection System Pumping t Treatment&Disposal :__,:;,, ,~ _'�•: - Customer Accounts Administrative&General la ~ Reclaimed Water Treatment Reclaimed Wq e Distribution i FV L cl Total Allowed Board Members Filed BOYCE FORMS•SYSTEMS 1-800-382-8702 325 APPLICATION AND CERTIFICATION FOR PAYMENT PAGE ONE OF 1 PAGES 2 TO OWNER: PROJECT: Proposed Renovations APPLICATION NO: Ret Distribution to: City of Carmel,Indiana-Board of Public Works and Safety Second Floor Unit Located 30 W.Main St OWNER One Civic Square Contract No.91 root ARCHITECT Carmel,IN 46032 PERIOD TO: 10/31/13 =CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: MAWR Design,Inc e JBM Contractors Corp 849 South Park Drive 5299 W Old 106th Street Carmel,Indiana PROJECT NOS: JBM 13-18 Zionsville,Indiana 46077 CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies ihat to the best of the Contractoes knowledge, Application Is made for Payment,as shown below,In connection with the Contrail. 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 which previo rtifications for Payment were Issued and payments received from the Owner d that current payment shown herein Is now due. 1 ORIGINAL CONTRACT SUM $ 164,918.00 2 Net change by Change Orders $ 14,338.00 CONTRA 3 CONTRACT SUM TO DATE(Line 1+2) $ 179,256.00 CONT OR: 4 TOTAL COMPLETED&STORED TO $ 179,256.00 DATE (Column G on G703) By: t 5 RETAINAGE: a. 0 %of Completed Work !!late of: Cof"Notary HAEL JOHN STUERENSERG _ (Column D+Eon G703) $ 0.00 SubIced and sworn to before day of S�Ab. %of Stored Material NotublEc:�(Column F on G703) $ Mymission expires: PUbI1C;State of Indiana Total Retainage(Une Sa+Sb or y Commission Expires Feb.22,2020 Total In Column I of G703) S 0.80 ARCHITECT'S CERTIFICATE FOR PAYMEWr 6 TOTAL EARNED LESS RETAINAGE $ 179,256.00 In accordance with the Contract Documents,based an onsite observations and the data (Une 4 less Une 5 Total) comprising this application,the Arrhltact certifies to the Owner that to the best of the 7 LESS PREVIOUS CERTIFICATES FOR Arrhiteces knowiedge,Information and belief the Work has progressed as indicated, PAYMENT(Une 6 from prior Certificate) $ 170,293.20 the quality of the Work Is In accurdancewith the Contract Documents,and the Contractor i 8 CURRENT PAYMENT DUE $ 8,962.80 Is entitled to payment of the AMOUNT CEK FLED. 9 BALANCE TO FINISH,INCLUDING RETAINAGE $ 0.00 (Une 3 less Urge 6) AMOUNT CERTIFIED............._.........._.......$ 8,962.80 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation ifamountcert(fieddif/eafmmthe amount applied.laitlalbil fguresonthis Total changes approved in Applicotion and on the Codtiniodon5heetth0tore ranged to conform with theom mucertifled) previous months by Owner 0.00 ARCHITECT: Total aproved this Month 14,338.00 0.00 By: Date: This Certificate Is not negotiable.The AMOUNT CERTIFIED Is payable only to the TOTALS 14,338.001 0.00 Contractor named herein.Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract NET CHANGES by Change Order 14,338.00 I i CONTINUATION SHEET AIA DOCUMENT G703 pmtr,ctwm on,eveneside) PAGE TWO OF TWO PAGES AIA Document G702,APPLICATION AND CERTIFICATE FOR PAYMENT,containing APPLICATION NO.: Ret Contractor's signed Certification Is attached. PERIOD TO: 10/31/13 In tabulations below,amounts are stated to the nearest dollar. PROJECT NOS: IBM 13-18 Use Column I on Contracts where variable retainage for line Items may apply. A B C D E F G H I SCHEDULED WORK MATERIALS TOTAL ' VALUE COMPLETED PRESENTLY COMPLETED FROM PREVIOUS STORED AND STORED BALANCE ITEM DESCRIPTION OF ESTIMATED APPLICATION (NOT IN TO DATE % TO FINISH 0.0% ! NO. WORK COST (O+E) THIS PERIOD DORE) (D+E+F) (G:C) (C-G) RETAINAGE Division 1-General Conditions 1 General Conditions-malarial 4,930 4,930.00 0.00 0.00 4,930.00 100% 0.00 0.00 2 General Conditions-labor 950 950.00 0.00 0.00 950.00 100% 0.00 0.00 3 Supervision 6,000 6,000.00 0.00 0.00 6,000.00 100% 0.00 0.00 4 OH&P 16,985 16,985.00 0.00 0.00 16,985.00 100% 0.00 0.00 DIVISION 2-Site Construction 7 Demolition 9,000 9,000.00 0.00 0.00 9,000.00 100% 0.00 0.00 Division 4-Masonry 8 Stone Veneer 0 0.00 0.00 0.00 0.00 100% 0.00 0.00 DIVISION 6-WOODS&PLASTICS 11 framing 11,500 11,500.00 0.00 0.00 11,500.00 100% 0.00 0.00 12 finish carpentry 0 0.00 0.00 0.00 0.00 100% - 0.00 13 Casework 4,150 4,150.00 0.00 0.00 4,150.00 100% 0.00 O.W DIVISION 8-DOORS&WINIDOWS 0.00 17 steel doors and frames 5,970 5,970.00 0.00 0.00 5,970.00 100% 0.00 0.00 18 labor 2,700 2,700.00 0.00 0.00 2,700.00 100% 0.00 0.00 Glass and Glazing 10,900 10,900.00 0.00 0.00 10,900.00 100% 0.00 0.00 DIVISION 9-FINISHES 0.00 19 drywall i gypsum board 14,500 14,500.00 0.00 0.00 14,500.00 100% 0 D 0.00 Acoustical celting 6,000 6,000.00 0.00 0.00 6,000.00 100% 0.00 j 20 Flooring 23,400 23,400.00 0.00 0.00 23,400.00 100% 0.00 0.00 21 painbrig and staining 5,900 5,900.00 0.00 0.00 5,900.00 100% 0.00 0.00 DIVISION 10-SPECIALTIES 0.00 22 toilet and bath accessories 0 0.00 0.00 OAO 0.00 100% 0.00 j 0.00 23 fire extinguishers-wall mounted 10lbs 300 300.00 0.00 0.00 300.00 100% 0.00 0.00 24 labor 50 50.00 0.00 0.00 50.00 100% 0.00 0.00 DIVISION 22-PLUMBING i 0.00 25 Plumbing rough and finish 3,050 3,050.00 0.00 0.00 3,050.00 100% 0.00 0.00 26 Fire Suppression 5,450 5,450.00 0.00 0.00 5,450.00 100% 0.00 0.00 DIVISION 23-HVAC 0.00 27 HVAC Rough and Finish 11.683 11,683.00 0.00 0.00 11,683.00 100% 0.00 0.00 DIVISION 26-ELECTRICAL 0.00 28 Electrical rough in and finish 21,500 21,500.00 0.00 0.00 21,500.00 100% 0.00 0.00 29 CO#1-26 Conduits 1,450 1,450.00 0.00 0.00 1,450.00 100% 0.00 0.00 30 CO#2-Add base cabinet 325 325.00 0.00 0.00 325.00 100% 0.00 ! 0.00 31 CO#3-Electdcal work 1,595 1,595.00 0.00 0.00 1,595.00 100% 0.00 0.00 32 CO#4-Paint corridor&ceiling 825 825.00 0.00 0.00 825.00 100% 0.00 0.00 33 CO#5-Fire resistant wrap 6,523 6,523.00 0.00 0.00 6,523.00 100% 0.00 0.00 34 CO#6-Lights,switches acid doors 3,620 3,620.00 0.00 O.DD 3,620.00 100% d.00 0.00 i 179,256.00 179,256.00 0.00 OAD 179,256.00 100.0% 0.00 0.00 AIA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT 1992 EDITION AIA 1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK ' AVENUE,N.W.,WASHINGTON,D.C.20006-5292 6703-1992 i loft Prescribed by State Board of Accounts Form No.M-S(Rev.1997) ACCOUNTS PAYABLE VOUCHER TO ADDRESS Invoice Date Invoice Number Item Amount I 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 Mo. Day Yr. Signature Title 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. Mo. Day Yr. Officer Title Voucher No. Warrant No. ACCOUNTS PAYABLE DETAILED ACCOUNTS MUNICIPAL WASTEWATER UTILITY ACCT CARMEL, INDIANA th eoN f 4pjrs 5219 to ole( 106H7 St' -z tov:i le TIv y60 I Total Amount of Voucher $ Deductions 90 2 OS.o Amount of Warrant $ Month of Yr Acct. VOUCHER RECORD No. Collection System Pumping Treatment&Disposal Customer Accounts ` = t Administrative&GeneralY . mss' Reclaimed Wate Treatment S Reclaimed W rri tin Total Allowed Board Members Filed BOYCE FORMS•SYSTEMS 1-800-382-8702 325