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HomeMy WebLinkAbout228681 1/28/2014 *F CITY OF CARMEL, INDIANA VENDOR: 363785 Page 1 of 1 ONE CIVIC SQUARE PURDY MASONRY, INC CHECK AMOUNT: $13,160.00 ,o CARMEL, INDIANA 46032 7601 INDIANAPOLIS ROAD ZIONSVILLE IN 46077 CHECK NUMBER: 228681 CHECK DATE: 1/28/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460807 31554 18 13 , 160 . 00 DELAY CLAIM CHG ORDER Document G732TM — 2009 ;.4. Application and Certifica for Payment, Construction Manager as Adviser Edition TO OWNER: CITY OF CARMEL BY.A THROUGRROJECT: Parcel 7A-Reg. Perf.Arts Cntr APPLICATION NO 1 g DISTRIBUTION TO: IT'S REDEVELOPMENT dMMISSIONi OWNER CARMEL, IN C _ PERIOD TO. 11/30/2013 CONSTRUCTION MANAGER FROM r� VIA NSTRUCTION CONT..RACT DATE: ARCHITECT Purdy Masonry, I c.~� H 1/8/2008 CONTRACTOR MA .GER: 7601 Indiana bad SHIEL SEXTON COMPANY PROJECT NOS: 2695 CONTRACTOR Zionsville, IN 46�7� �f FIELD CONTRACT FOR: L r, `i VI ARCHITECT: CSO ARCHITECTS OTHER CONTRACTOR'S APP 10 FOlection AYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and Y - . belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in _1. with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous AIA Document G703 TM,Continuation Sheet,is attacl_eCertificates for Payment were issued and payments received from the Owner,and that current payment 1.ORIGINAL CONTRACT SUM............................................................$ 1 45o non no shown herein is now due. 2.NET CHANGES IN THE WORK..........................................................$ 31,1 n1 gn CONTRACT;�2R�rVy' 7Zn 21� 3.CONTRACT SUM TO DATE(Line 1 f 2) ............................... $ By: Date 11481,101,28 4.TOTAL COMPLETED AND STORED TO DATE:( olumn G on G703)............. $ State of: 1,481,191.PA IN 5.RETAINAGE: County of: BOONE a. %of Completed Work Subscribed and sworn to before Stefanie Pricy 0 P Notary PubliScal Sr t of Indiana (Column D+Eon G703) $ 0.00 me this `3 day of ��U ' Hend c{s of rtty 1 My Comr iissio E ?_Ii GS 06129120.117 G703) b• n no%of Stored Material Notary Public: •,���.,t},.�w .ti.�+��,LL.+ JM• `j�r'� (Column:Fon $ 0.00 M Commission ex ires ...........$ CERTIFICATE FOR PAYMENT Total Retainage(Lines Sa+Sb, or Total in Column I on G703)........ �on 6.TOTAL EARNED LESS RETAINAGE................................................... $148110120 In accordance with the Contract Documents,based on evaluations of the Work and the data comprising (Line 4 minus Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT.................................... 1 4r;7 a4n rn knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in (Line 6from prior Certificate) accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT 8.CURRENT PAYMENT DUE.................................... CERTIFIED.rn tow 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED.......................................................$ j t(0,0 (Attach explanation if amount certified differs from th mount applied.Im ial all frgures on this (Line 3 minus Line 6) $ a 09 Aiplicaon and o e Continuation Sh that ar chan ed to,conform with the amount certified.) CUCTION R:B SUMMARY OF CHANGES IN THE WORK ADDITIONS DEDUCTIONS ACT: :I tiple Prime Contractors are responsible for rformi g portions of the Total changes approved in previous months by Owner $ $ Proj he itect's Cert tion rs not required.) II 2 Total approved this month,including Construction By; Date: 2, Change Directives $ Thi Certi cate i not negotia le.The AMOUNT CERTIFIED is payabl only t the Contractor named TOTALS $ he ein. I uanc payment an acceptance of payment are without prejudice to any rights of the Owner NET CHANGES IN THE WORK or ractor un e_. ntract. CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G732TM—2009(formerly G702TMCMa—1992).Copyright©1992 and 2009 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 00)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. AIA == Document G732TM - 2009 Instructions Application and Certificate for Payment, Construction Manager as Adviser Edition GENERAL INFORMATION Purpose.AIA Document G732TM-2009,Application and Certificate for Payment,Construction Manager as Adviser Edition,is to be used in conjunction with AIA Document G703TM-1992,Continuation Sheet.These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner,but not as a constructor.Procedures for their use are covered in AIA-Document A232Tm 2009,General Conditions of the Contract for Construction,Construction Manager as Adviser Edition. Related Documents.AIA Document G703-1992. 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-eights to reproduce this document.The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G732-2009,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. USING G732-2009 After the Contractor has completed AIA Document G703,Continuation Sheet,summary information should be transferred to AIA Document G732-2009,Application and Certificate for Payment,Construction Manager as Adviser Edition.The Contractor should sign G732,have it notarized and submit it,together with G703,to the Construction Manager and Architect.The Construction Manager and Architect should review G732 and G703 and,if they are acceptable,complete'the Certificate for Payment on G732.The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A232Tm-2009.They should then initial all figures on G732 and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G732 and G703 should be forwarded to the Owner. COMPLETING G703 Heading.This information should be completed to be consistent with similar information on AIA Document G732-2009,Application and Certificate for Payment,Construction Manager as Adviser Edition. Columns A,B and C.These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of values submitted at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project:Multiple pages should be used when required. " Column C.Shouldbesubtotaled at-the bottom when more than one page is used and totaled on the last page.Initially,this total should equal the original Contract Sum.The total of column C may be adjusted by Change Orders during the Project: Column D.Enter in this column the amount of completed work covered by the previous application(columns D&E from the previous application).Values from column F(Materials Presently Stored)from the previous application should not be entered in this column. Column E.Enter here the value of Work completed at the time of this application,including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored(column F). Column F.Enter here the value'of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period.This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period). Column G.Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H.Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I.This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount,. ;"- Change Orders and Construction Change Directives.The amount of the original contract,'adjusted by Change Orders and amounts authorized for Construction Change Directives as reflected in line 2,is to be entered on line 3 of the G732 form. MAKING PAYMENT The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manag&4drid Architect on AIA Document G732-2009,Application and Certificate for Payment,Construction Manager4s Adviser Edition.The completed form contains the name and address of the Contractor.Payment should not be made to any other party unless specifically indicated on G732. AIA Document G732TM-2009(formerly G702TMCMa-1992).Copyright @ 1992 and 2009 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. TM Document G703 - 1992 Continuation Sheet AIA Document G702TM1992,Application and Certificate for Payment,or G732Tm-2009, APPLICATION M Application and Certificate for Payment,Construction Manager as Adviser Edition, 18 iii ; APPLICATION DATE: containing Contractor's signed certification is attached. 11/14/2013 In tabulations below,amounts are in US dollars. PERIOD TO: 11/30/2013 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO. 2695 A B C D E F G H 1 WORK COMPLETED MATERIALS TOTAL BALANCE TO ITEM DESCRIPTION OF WORK FROM PREVIOUS FINISH SCHEDULED PRESENTLY COMPLETED AND % RETAINAGE NO. VALUE APPLICATION THIS PERIOD STORED STORED TO DATE (G-C) (C_G) (If variable rate) (D+E) (Not in D or E) (D+E+F) 1 BOND 14,500.00 14,500.00 0.00 0.00 14,500.00 100.00 0.0c 0.00 2 SUBMITTALS 24,000.00 24,000.00 0.00 0.00 24,000.00 100:00, 0.0C 0.00 3 MOCKUP 1,000.0c 1,000.0c 0.00 0.00 1,000.00 100.00 0.0c 0.00 4 MOBILIZATION 1 0,000.0c 1 0,000.0c 0.00 0.00 10,000.00 : 100.00 0.0c 0.00 5 CLEAN UP 20,000.00 20,000.0 0.00 0.00 201000.00 100.00 0.0c 0.00 6 SAFETY 20,000.00 20,000.00 0.00 0.00 20,000.00 100.00 0.0c 0.00 7 ORIENTATION' 3,000.0c 3,000.00 0.00 .0.00 3,000.00 100.00 0.0c 0.00 8 REBAR MATERIAL 59,000.00 59,000.00 0.00 0.00 59,000.00 100.00 0.0c 0.00 9 REBAR LABOR 40,000-OC 40,000.00 0.00 0.00 40,000.00 100.00 0.0c 0.00 10 GROUT MATERIAL 105,000.0C 105,000.00 0.00 0.00 105,000.00 100.00 0.0c 0.00 11 GROUT LABOR 200,000,OC 200,000.00 0.00 0.00 200,000.00 100.00 0.0c 0.00 12 JOINT REINFORCEMENT 23,000.00 0.0c 0.00 23,000.00 23,000.00 100.00 0.0C 0.00 13 WELD ON ANCHORS MATERIAL 14,000-OC 0.00 0.00 14,000.00 14,000.00 100.00 0.0c 0.00 14 WELD ON ANCHORS LABOR 19,000.0c 19,000.00 0.00 0.00 19,000.00 100.00 b.0c 0.00 15 NORTH SIDE o.bc 0.00 0.00 0.00 0.00 0.00 0.0c 0.00 16 CMU MATERIAL 40,000.00 40,000.00 0.00 0.00 40,000.00 100.00 0.0c 0.00 17 CMU LABOR 130,000-OC 130,000.00 0.00 0.00 130,000.00 100.00 0.0C 0.00 18 EAST SIDE 0.0c 0.00 0.00 0.00 0.00 0.00 0.0c 0.00 19 CMU MATERIAL 45,000.0 45,000.0 0.00 0.00 4b,000.00 100.00 0.0C 0.00 20 CMU LABOR 137,625.00 137,625.00 0.00 0.00 137;625.00 100.00 0.0c 0.00 21 SOUTH SIDE 0.0c 0.00 0.00 0.00 0.00 0.00 0.0 0.00 GRAND TOTAL CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703TM-1992.Copyright©1963, 1965,1966,1967,1970,1978,1983 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. 101210AGD44 mm- AIA Document G703"- 1992 instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents.AIA Document G703TIM,Continuation Sheet,is to be used in conjunction with AIA Document G702TM Application and Certificate for Payment,or AIA Document G732TA1 Application and Certificate for Payment,Construction Manager as Adviser Edition.These documents are designed for use on Projects where the Contractor has a_direct Agreement with the Owner. Procedures for their use are covered in AIA Documents A20ITM,General Conditions of the Contract for Construction,and A232TM,General Conditions of the Contract for Construction,Construction Manager as Adviser Edition. 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 AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703,but only for use in connection with a particular project.The AIA will not pen-nit 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 G703-1992 Heading.This information should be completed in a manner consistent with similar information on AIA Document G702,Application and Certificate for Payment,or G732TM,Application and Certificate for Payment,Construction Manager as Adviser Edition,whichever is applicable. Columns A,B and C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page.Initially,this total should equal the original Contract.Sum.The total of column C may be adjusted by Change Orders during the Project. Column D.Enter in this column the amount of completed Work covered by the previous application(columns D&E from the previous application).Values from column F_(Materials Presently Stored)from the previous application should not be entered in this column. Column E.Enter here the value of Work completed at the time of this application,including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored(column F). Column F.Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period.This value covers both materials newly stored for which payment is sought and materials previously stored which are riot yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into Column E(Work Completed-This Period.) Column C.Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H.Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column 1.This column is normally used only for contracts where variable retainage is permitted on a line-item basis.It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders.Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 or G732 form,whichever is applicable. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 of AIA Document A201 or Section 7.3 of AIA Document A232. The following is an evantple of a Continuation Sheet for work in progress.Please note that dollar amounts shown belon'are for illtestrative purposes only,and ore not intended to reflect actual consnvelion costs. A R C D L' F G H I WORK COMPLETED MATERIALS TOTAL BALANCE COMPLETED ITEM SCHEDULED FROM PREVIOUS PRESENTLY % TO RF.TAINAGIi NO DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (G=C) TO (tJariohle rare) (D+E) (Na m Dor El TO DATE (C-G) D+E+Fj 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CUR85&MISC.CONC. 5,000 0 0 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING,LOWER DRIVE 20,000 0 0 0 0 0 20',000 8 PAVERS 20,000 0 0 10.000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 GRANDTOTAL 105,000 20,000 10,000 10,000 40,000 65,000 AIA Document G703TM-1992.Copyright @ 1963,1965,1966,1967,1970,1978,1983 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 reprodilce 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. TM IIII&AIA Document 6703 ® 1992 Continuation Sheet AIA Document G702TM1992 Application and Certificate for Payment,or G732TM-2009, APPLICATION NO Application and Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE: 18 containing Contractor's signed certification is attached. 11/14/2013 In tabulations below,,;amounts are in US dollars. PERIOD TO: 11/30/2013 Use Column lI on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 2695 A B C D E F -.: G H 1 WORK COMPLETED MATERIALS TOTAL BALANCE TO ITEM DESCRIPTION OF WORK FROM PREVIOUS FINISH SCHEDULED PRESENTLY COMPLETED AND % RETAINAGE NO. VALUE APPLICATION THIS PERIOD STORED STORED TO DATE (G=C) (C-G) fif variable rate) (D+E) (Not in D or E) (D+E+F) 22 CMU MATERIAL 50,000.00 50,000.00 0.00 0.0C 50,000-OC I 00.0c 0.00 0.00 23 CMU LABOR 145,250.00 145,250.00 0.00 0.0c 145,250.0 109,0(10.0 0.00 24 WEST SIDE 0.0c 0.0 0.00 0.0c 0.0c 0.00 0.00 25 CMU MATERIAL 45,000.00 45,000.00 0.00 0.0c 45,000.00 11 100.OC 0.00 0.00 26 CMU LABOR 130,625.0C 130,625.00 0.00 0.0c 130 625.00 100.0c 0.00 0.00 27 MORTAR&SAND 25,000.0 25,000-OC 0.00 0.0c 1 00.0c 0.00 0.00 28 ACCESSORIES 10,000.0c. 10,000.0 0.00 0:0C10,000.0 100.0 0.0 0.00 29 UPPER DRUM 0.0c 0.0C 0.00 0:0C 0.0c 0.0c 0.00 0.00 30 CMU MATERIAL 15,000.0 15,000-0C 0.00 0.00 15,000.0C 100.0 0.0 0.00 31 CMU LABOR 90,000.0c 90,000.0c 0.00 0.00 90,000.0c 100.0 0.0 0.00 32 GROUT MATERIAL 11,500.00 11,500.00 0.00 0.00 11,500.00 100.0 0.0 0.00 33 GROUT LABOR 20,000.00 20,000.00 0.00 0.00 20,000.00 100.0 0.0 0.00 34 MORTAR&SAND 2,500-OC 2,500.00 0.00 0.00 2,500.00 100.0 0.0 0.00 35 ALLOWANCE CORRECTION -5,000.0 -5,000.00 0.00 0.00 -5,000.00 100:0 0.0 0.00 36 CHANGE ORDER#1 0.0c 0.00 0.00 0.00 0.0c 0.0 0.0 0.00 37 CHANGE ORDER#2 8,279.1 8,279.15 0.00 0.00 8,279.1 E 100.0 0.0 0.00 38 CHANGE ORDER#3 9,661.45 9,661.45 0.00 0.00 9,661.4 100.0, 0.0 0.00 39 ALLOWANCE 5,000-00 5,000.00 0.00 0.00 5,000 0 100:0 0.0 0.00 40 CHANGE ORDER#4 13,160.60 0.00 13,160.60 0.00 131160.6 100.0 0.0 0.00 GRAND TOTAL $1,481,101.20 $1,430,940.60 $13,160.60 $371000.00 $1,481,101.2 100.0c Moll $0.00 CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703TM-1992.Copyright©1963, 1965,1966,1967,1970,1978, 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(i o)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. 101210AGD44 AIA Document G703"- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents.AIA Document G703TM,Continuation Sheet,is to be used in conjunction with AIA Document G702TM Application and Certificate for Payment,or AIA Document G732TM,Application and Certificate for Payment,Construction Manager as Adviser Edition.These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Documents A201 TM,General Conditions of the Contract for Construction,and A232TM,General Conditions of the Contract for Construction,Construction Manager as Adviser Edition. 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 AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703,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 G703-1992 Heading.This information should be completed in a manner consistent with similar information on AIA Document G702,Application and Certificate for Payment,or G732TM,Application and Certificate for Payment,Construction Manager as Adviser Edition,whichever is applicable. Columns A,B and C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially,this total should equal the original Contract Sum.The total of column C may be adjusted by Change Orders during the Project. Column D.Enter in this column the amount of completed Work covered by the previous application(columns D&E from the previous application).Values from column F(Materials Presently Stored)from the previous application should not be entered in this column. Column E.Enter here the value of Work completed at the time of this application,including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored(column F). Column F.Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period.This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period.) Column G.Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H. Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I.This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders.Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule.The amount of the original contract adjitsted'hy'Change Orders is to be entered in the appropriate location on the G702 or G732 form,whichever is applicable. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 of AIA Document A201 or Section 7.3 of AIA Document A232. The follolving is an erample ofa Continuation Sheer for work in progress.Please note that dollar amounts shoxn belovi,m-e for illustrative proposes only,and are not intended to reflco actual consnvctlon costs. A B C D E P G H WORK COMPLETED MATERIALS TOTAL BALANCE FROM PREVIOUS COMPLETED ITE\7 SCHEDULED PRESENTLY % TO RI;"rAINACi I: DESCRIPTION OF WORK AND STORED NO. VALUE APPLICATION THIS PI;ILIOD STORED (G+C) FINISH (/Jrorioble rnmJ (D+E) (va in Dor E) TO DATE (C G) (D+E+F) I MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS&MISC.CONC. 5,000 0 0 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING,LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 GRAND TOTAL 105,000 20,000 10,000 10,000 1 40,000 1 65,000 AIA Document G703TM-1992.Copyright©1963,1965, 1966,1967,1970,1978,1983 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 Ale 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. NOV 15 2013 �u WAIVER OF LIEN FINAL X PARTIAL PAYMENT TO FOLLOW X DON PURDY BEING DULY SWORN THAT HE IS PRESIDENT OF PURDY MASONRY, INC. AND HAVING CONTRACTED WITH CITY OF CARMEL BY AND THROUGH IT'S REDEVELOPMENT COMMISSION TO FURNISH CERTAIN LABOR & MATERIAL FOR THE PROJECT KNOWN AS PARCEL 7A-REG. PERFORMING ARTS CENTER LOCATED IN CARMEL, IN AND OWNED BY CITY OF CARMEL BY AND THROUGH IT'S REDEVELOPMENT COMMISSION DOES FURTHER STATE: MASONRY THE AMOUNT WHICH IS DUE FROM THE OWNER IS THE SUM OF: THIRTEEN THOUSAND ONE HUNDRED SIXTY DOLLARS AND 60/100. $13,160.60 THE PAYMENT WHICH HAS BEEN PROMISED AS THE SOLE CONSIDERATION FOR THIS AFFIDAVIT AND PARTIAL WAIVER OF LIEN WHICH IS GIVEN TO AND FOR SAID AMOUNT, EFFECTIVE UPON RECIEPT OF PAYMENT. PURDY MASONRY, INC. d� RESIDENT WITNESS MY HAND AND NOTORIAL SEAL THIS 13TH DAY OF NOVEMBER 2013. aiL&9�4 JQ:10 EFANIE PURDY MY COMMISSION EXPIRES: 6/29/17 COUNTY OF RESIDENCE: HENDRICKS Puvdy Svo of Indiana nur,r;:S COUntV CITY OF CARMEL TO: Purdy Masonry,Inc. CONTRACT CHANGE ORDER NO.: 4 7601 Indianapolis Rd. DATE: November 11,2013 Zionsville,IN 46077 PROJECT NAME: Carmel–RPAC Construction C17FY REQ.NO.: CITY PO NO.: CITY PO DATE: 1. You are directed to make the following changes in this Contract: SCHEDULED ADJUSTMENT ITEM AMOUNT H OR(-)DAYS I. Perform all Emergency Work in accordance with Work Directive Change No.3020-001 $10,000.00 Per Work Directive Change No.3020-001 This Change Order 2695-3020 No.04 supersedes Change Order 2695-3020 No.01. 2. Reimburse previously unpaid Time&Material rebar for Emergency Work per Purdy Masonry Invoice#81,dated 10/01/09,to include partial Purdy Brick Supply Invoice#2245 for$4,788 less$1,654 paid via Purdy Masonry Invoices#59 thru#80-unpaid amount=$3,134 plus mark-up. $3,160.60 II. The following reference Documents further describe the changes outlined in Paragraph I,and are to be considered a part of this Change Order: R.F.P.: W.D.C.No.: 3020-001 The changes result in the following adjustment of Contract Price and Contract Time: Contract Price prior to this Change Order $ 1,467,940.60 Contract Price will be increased by this Change Order $_ 13,160.60 New Contract Price including this Change Order $ 1,481,101.20 Contract Time Prior to this Change Order 8NOV 10 was Project Substantial Completion Date Net increased/decreased resulting from this Change Order 0 Days Current Contract Time including this Change Order 8NOV 10 is Revised Project Substantial Completion Date This Change Order is for a release of and full and final settlement of all direct,indirect,impact costs,time extensions and all claims incurred of or by contractor at any time resulting from the changes to the Contract relating to or arising out of the suspension and disruption of the Project due to the steel remediation work from June 17,2009 on. The Above Changes Are The Above Changes Are Recommended: Accepted: prove Shiel Sexton Company Inc. Purdy Masonry,Inc. Construction Manager Contractor it is F comer ' e s i d e n t 902 N.Capitol Avenue 7601 Indianapolis Road Address Address Indiana li IN 46204 Zionsville,IN 46077 Ci /S to/Zip City/State/Z' B By: Phone:-511— Phone 7W- Date: Date: t��a-� 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. N3'w) /P,ayee�r- PLSrI r Y � !�) Purchase Order No. -760 t r � � Terms Z') Ui ��� ,,� 6017 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 1130-�� m e 014e I'3606160 W04 L� NM.&A-ukm Total 3 (6 0. Q 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 kPJ4 d4lahtyl-I'v, IN SUM OF $ WO/ 1' �J iaAtjj�s RnJ iI./'V 077 $ 13, 160, �0 ON ACCOUNT OF APPROPRIATION FOR Tj F 9 0)-,/ Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# 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 201 Matdre� Cost distribution ledger classification if Title claim paid motor vehicle highway fund