HomeMy WebLinkAboutJob 9603CEInvoice Date:
2/5/03
Invoice Number:
03-051.3
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
CustomerlD: JEFFBOPW
Professional Services
Description
JOB %9603CE - VETEP~NS PARKWAY INSPECTION - PROJECT NO. SIB-C730(), DES NO.
9880130
Amount
21,990.26
Total Invoice Amount
21,990.26
Prescribed by the State Board of Accounts City Form No. 201 (Rev, 1964)
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 YAP. D, PER HUNDRED, PER POUND, PER TON. ETC.
DEPARTMENT OF REDEVELOPMENT, CITY OF JEFFERSONVILLE
On Account of Appropriation for To ]ACOBI, TOOMBS AND LANZ, INC
Address 120 BELL A VENUE~ CLARKSViLLE IN 47129
DATE ORDER ITEMIZED CLAIM DOLLARS CTS.
2003
NO.
2'S J O b # 9~; ~cEt; oV.e;~a.n; ~3~i)7 ~YEI~ s;~i t ~°8n80130
Total Charges to Date $89,301.34
Total Previous Charges $67,311.08
Total Due This Claim $21,990.26
Pursuant to the provision~ and penalties of Chapter ~5
I hereby certify that the foregoing account is just and c~br
all just credits, and that no part of the same has been pai~
\
Date Feb 5 20 03
-(
Acts of 1953.
that the amount claime~ due, after allow/ng
VETERANS PARKWAY INSPECTION
PROJECT NO. SIB-C7300, DES. NO. 9880130
JOB NO. 9603CE
INVOICE 4
Billing Date: February 5, 2003
AGENCY:
Federal Share Reimbursable
Total Local Share Split
Jeffersonville
Clarksville
FUNDING SUMMARY
SHARE OF
REIMBURSEMENT
80.00%
20.00%
60.00%
40.00%
TOTAL THIS INVOICE
AMOUNT DUE
THIS INVOICE
$ 17,592.20
$ 4,398.05
$ 2,638.83
$ 1,759.22
$21,990.2{
TOTAL REIMB
TO DATE
$71,441.08
$17,860.26
$10,716.16
$7,144.11
$89,301.34
VETERANS PARKWAY INSPECTION
PROJECT NO. SIB-C730(), DES. NO. 9880130
JOB NO. 9603CE
INVOICE 4
Billing Date: February 5, 2003
CLASSIFICTIONS
SENIOR ENGINEER (IHT)
SENIOR ENGINEER (IIL)
PROJECT MANAGER (TLS)
DESIGN ENGiNEER (MCH)
DESIGN ENGiNEER (HLH~
DESIGN ENGiNEER (HU)
CADD MANAGER (BTB)
DETAIL ENGiNEER (ARS)
CADD TECH (IA_M, KLP, LA_H)
CADD TECH (P, VL)
RES PROJ REP (VLL)
RES PROJ REP (IMC)
RES PROJ REP (JSS)
LAND SURVEYOR (KWJ)
SURVEY TECH (RLC)
SURVEY TECH (DES)
SURVEY TECH (JAT)
SURVEY TECH (CWO)
SURVEY TECH (KH)
SURVEY TECH (SBS)
KEG HRS OT HRS RATE TOTAL
1.00
5.50
21.00
11.00
30.00
155.00 12.50
141.00 3.00
102.50 2.00
$43.25 $0.00
$43.25 $43.25
$33.50 $184.25
$28.75 $0.00
$27.55 $0.00
$24.75 $519.75
$27.55 $0.00
$18.00 $198.00
$16.00 $480.00
$13.00 $0.00
$22.00 $3,685.00
$18.25 $2,628.00
$16.85 $1,760.83
$19.75 $0.00
$16.I5 $0.00
$16.15 $0.00
$14.50 $0.00
$I3.25 $0.00
$12.50 $0.00
$12.50 $0.00
LABOR TOTAL
OVERHEAD %
99.04
TOTAL LABOR COSTS
$9,499.08
$9,407.88
$18,906.96
DIRECT NON-SALARY COSTS:
MILEAGE
OVERTIME PREMIUM ( O T hrs x Hrly Rate/2)
OTHER EXPENSES
252.00
17.50
0.00
$0.28
$70.56
$181.73
$0.00
TOTAL DIRECT NON-SALARY COSTS
$252.29
TOTAL FIXED FEE ALLOWED PER CONTRACT
FIXED FEE CHARGED TO THIS INVOICE
FIXED FEE CHARGED TO PREVIOUS INVOICES
$102,000.00
$2,831.01
$5,315.77
$2,831.01
FIXED FEE BALANCE
$93,853.22
TOTAL THIS INVOICE
521,990.26
INDIANA DEPARTMENT OF TRANSPORTATION
LPA CLAIM VOUCHER
State Form 40340 (R6/5-99) Approved by State Board Accounts 1999
Instructions: This agency is requesting disclosure of your Social Security number in accordance with LC. 4-1-8.
3OCUMENT NUMBER
0800
VENDOR INFORMATION
Date (MM,DD,YY)
02/05/03
AGENCY INFORMATION
AGENCY NAME
INDOT
VENDOR NAME AGENCY NUMBER
JEFFERSONVILLE DEPARTMENT OF REDEVELOPMENT 800
ADDRESS ;OClAL SECURITY NUMBER
CITY-COUNTY BLDG, ROOM 403 0
FEDERAL I.D. NUMBER
0
CITY STATE ZiP VENDOR
JEFFERSONVILLE IN 47130 0
AMOUNT DESCRIPTION/1099 IND
DATE (MM,DD,YY)
AREA BELOW TO BE COMPLETED BY AGENCY
FUND [ OBJECT I CENTER
NO
EXEMPT PER I.C, 5-'17-5~2
TOTAL AMOUNT: $0.00 DOC I.D.: PV 800
NO
INDOT ACCOUNTING LiNE DISTRIBUTION
iNVOICE JOB/PROJECT
LN NUMBER FUND AGCY ORG APPR UNIT AC'IV OBJ NUMBER PRTY AMOUNT
01 800
02 800
03 800
LINE NO.
1 Claim NO. 4 Project/Job No. SIB-C7300, DES NO. 9880130
2 This claim voucher is for: (Preliminary) (R/W) (Const.) Engineering, Force Account or PJW 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)
I
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 pal
Sign of Vendor Official Title IDate (Month, Day, Year)