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HomeMy WebLinkAbout04K ~ Invoice Date: 2/5/03 Invoice Number: 03-0513 JACOBI, TOOMBS AND LANZ, INC. • Consulting Engineers 120 Bell Avenue Clarksville, Indiana 47129 (812) 288-6646 JEFFERSONVILLE BOPW c/o BOB MILLER CITY-COUNTY BLDG, 4TH FLOOR JEFFERSONVILLE, IN 47130 CUStomer ID: JEFFBOPW Professional Services Description JOB #9603CE - VETERANS PARKWAY INSPECTION - PROJECT N0. SIB-C730(), DES NO. 9880130 Total Invoice Amount Amount 21,990.26 21,990.26 • '< {'rescribed by the State Board of Accounts CLAIM A CLAIM, TO BE PROPERLY ITEMIZED, MUST SHOW: KIND OF SERVICE, WHERE PERFORMED, DATES SERVICE RENDERED, BY WHOM, RATE PER DAY, NUMBER OF HOURS, RATE PER HOUR, PRICE PER FOOT, PER YARD, PER HUNDRED, PER POUND, PER TON, ETC. DEPARTMENT OF REDEVELOPMENT, CITY OF JEFFERSONVILLE •On Account of Appropriation for 'I'o JACOBI, TOOMBS AND LANZ, INC DATE 2003 ORDER NO. ITEMIZED CLAIM DOLLARS CTS. 2/S Job #9603CE -Veterans Parkway Inspection Project No. SIB-C730Q, DES. No. 9880130 $21,990.26 Total Charges to Date $89,301.34 Total Previous Charges $67,311.08 Total Due This Claim $21,990.26 Address 120 BELL AVENUE, CLARKSVILLE IN 47129 City Form No. 201 (Rev. 1964) Pursuant to the provisions and penalties of Chapter 1 Acts of 1953. I hereby certify that the foregoing account is just and rrec that the amount claimed is all just credits, and that no part of the same has been pai Date Feb 5 20 03 due, after allowing President TITLE ~~ •---- ~~ ' ~ • AGENCY: Federal Share Reimbursable Total Local Share Split Jeffersonville Clarksville VETERANS PARKWAY INSPECTION PROJECT NO. SIB-C730(), DES. NO. 9880130 JOB NO. 9603CE INVOICE 4 Billing Date: February 5, 2003 FUNDING SUMMARY SHARE OF AMOUNT DUE REIMBURSEMENT THIS INVOICE 80.00% $ 17,592.20 20.00% $ 4,398.05 60.00% $ 2,638.83 40.00% $ 1,759.22 TOTAL THIS INVOICE $21,990.26 TOTAL REIMB TO DATE $71,441.08 $17,860.26 $10,716.16 $7,144.11 $89,301.34 ~, ~~~ , TOTAL THIS INVOICE /~ $21,990.26 • VETERANS PARKWAY INSPECTION PROJECT NO. SIB-C730(), DES. NO. 9880 130 JOB NO. 9603CE INVOICE 4 Billing Date: February 5, 2003 CLASSIFICTIONS REG HRS OT HRS RATE TOTAL SENIOR ENGINEER (JHT) $43.25 $0.00 SENIOR ENGINEER (JIL) 1.00 $43.25 $43.25 PROJECT MANAGER (TLS) 5.50 $33.50 $184.25 DESIGN ENGINEER (MCH) $28.75 $0.00 DESIGN ENGINEER (HLH) $27.55 $0.00 DESIGN ENGINEER (HU) 21.00 $24.75 $519.75 CADD MANAGER (BTB) $27.55 $0.00 DETAIL ENGINEER (ARS) 11.00 $18.00 $198.00 CADD TECH QAM, KLP, LAH) 30.00 $16.00 $480.00 CADD TECH (RVL) $13.00 $0.00 RES PROJ REP (VLL) 155.00 12.50 $22.00 $3,685.00 RES PROJ REP (JMC) 141.00 3.00 $18.25 $2,628.00 RES PROJ REP (JSS) 102.50 2.00 $16.85 $1,760.83 LAND SURVEYOR (KWJ) $19.75 $0.00 SURVEY TECH (RLC) $16.15 $0.00 . SURVEY TECH (DES) $16.15 $0.00 SURVEY TECH (jAT) $14.50 $0.00 SURVEY TECH (CWO) $13.25 $0.00 SURVEY TECH (KH) $12.50 $0.00 SURVEY TECH (SBS) $12.50 $0.00 LAB OR TOTAL $9,499.08 OVERHEAD % 99.04 $9,407.88 TOTAL LABOR COSTS $18,906.96 DIRECT NON-SALARY COSTS: MILEAGE 252.00 $0.28 $70.56 OVERTIME PREMIUM (OT brs x Hrly Rate/2) 17.50 $181.73 OTHER EXPENSES 0.00 $0.00 TOTAL DIRECT NON-SALARY COSTS $252.29 TOTAL FIXED FEE ALLOWED PER CONTRACT $102,000.00 FIXED FEE CHARGED TO THIS INVOICE $2,831.01 $2,831.01 FIXED FEE CHARGED TO PREVIOUS INVOICES $5,315.77 FIXED FEE BALANCE $93,853.22 TOTAL THIS INVOICE $21,990 ~.~ ~~. \ // .16 '. INDIANA DEPARTMENT OF TRANSPORTATION • LPA CLAIM VOUCHER State Form 40340 (R6/5-99) Approved by State Board Accounts 1999 in~~.~~rHnnc• Tl.ic ~..e..n.~ it r ecfinn riierlnenrn of vnnr Cnri~l Rocnrity nitmhar in acnnrrianeP with I C 4-1-R VENDOR INFORMATION AGENCY INFORMATION CUMENT NUMBER Date (MM,DD,YY) AGENCY NAME CBOO 02/05/03 INDOT VENDOR NAME AGENCY NUMBER JEFFERSONVILLE DEPARTMENT OF REDEVELOPMENT 800 ADDRESS SOCIAL SECURITY NUMBER CITY-COUNTY BLDG, ROOM 403 0 FEDERAL I.D. NUMBER 0 CITY STATE ZIP VENDOR JEFFERSONVILLE IN 47130 0 HKCH CCLVW 1 V CC GVMYLC I CU DT Ab CIVI.T , NO NO EXEMPT PER I.C. 5-17-5-2 TOTAL AMOUNT: $0.00 DOC I.D.: PV 800 INDOT ACCOUNT ING LINE DI STRIBUTION INVOICE JOB/PROJECT LN NUMBER FUND AGCY ORG APPR UNIT ACTV OBJ NUMBER PRTY AMOUNT 01 800 02 800 800 LINE NO. 1 Claim No. 4 ProjecUJob No. SIB-C730Q, DES NO. 9880130 2 This claim voucher is for: (Preliminary) (R/W) (Const.) Engineering, Force Account or R/VV Costs 3 Project Description: VETERANS PARKWAY INSPECTION 4 Period covered by this claim voucher: From 12/20/2002 To 01 /30/03 5 Gross amount of previous claims $67,311.08 6 Net amount of previous claims $53,848.86 7 This (is) (is not) a final claim voucher 8 Gross amount of this Local Agency Claim $21,990.26 9 Federal Share Reimbursable (Line 8 x fed %) 80.00% $17,592.21 10 Net amount of Claim Voucher $17,592.21 RECOMMENDED FOR APPROVAL INDOT OFFICIAL INITIATING THE CHARGE DATE I certify that this claim is correct and valid and is a proper charge against the State Agency, Fund and Center indicated. Authorized Signature of State Agency Date (Month, Day, Year) Pursuant to the provisions and penalties of Indiana Code 5-11-10-1, I hereby certify that the foregoing Fund and Center is just and correct, that the amount claimed is legally due, after allowing all just credits, and that no part of the same has been poi Signof Vendor Official Title Date (Month, Day, Year) ~ 1r 0- V "~J