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HomeMy WebLinkAbout2010 COIT Bond pay request 49 082614 JUl W 0 0 0 IJ0�IJ, B© ll Q n n © ®0 CITY 0 'ARMEL JAib1E5 BI!\1NARI), MAYOR CITY OF CARMEL, INDIANA, REDEVELOPMENT AUTHORITY COUNTY OPTION INCOME TAX LEASE RENTAL REVENUE BONDS, SERIES 2010 CONSTRUCTION FUND DRAW REQUISITION NO. 49 Wells Fargo Attn: Scott Hagwell 10 South Wacker Dr., 13th Floor Chicago, IL 60606 312-726-2163 via email: scott.hagwell @wellsfargo.com Date: 25th of August , 2014 RE: City of Carmel Keystone Project Note-Depository Account 2010 The undersigned certifies that: (a) The undersigned is an officer of the City of Carmel, Indiana; (b) The amounts set forth on. Schedule A are requested to be paid from the City of Carmel Keystone Note-Depository Account 2010 (82280100); (c) Each obligation as reflected by the amounts set forth on Schedule A has been properly incurred, is a proper charge against the Keystone Note- Depository Account 2010 and has not been the basis of any previous withdrawal from the Depository Account; and (d) Supporting information with respect to each payee designated on Schedule A as to the amount owing is attached hereto. CITY OF CARMEL, INDIANA 4 BY: Diana L. Cordray, Clerk-Treasurer Authorized Officer 1)I:JAI INII '!' OF LNoI 'lEluNG ON:F CHIC C RvIFI, IN 46032 Oi icr 3 17.571.2«7 FA.y 317.571.2439 F lAlI. enginccrinvucarnicl,in.g()y SCHEDULE A TO CITY OF CARMEL,INDIANA,REDEVELOPMENT AUTHORITY COUNTY OPTION INCOME TAX LEASE RENTAL REVENUE BONDS,SERIES 2010 CONSTRUCTION FUND PAYMENT REQUISITION NO.49 25-Aug-14 AMOUNTS PAYEE'S NAME&MAILING ADDRESS REQUISITIONED COST ITEMIZATION • University High School of Indiana, Inc.and $203,000.00 Bridleborne Drainage Improvements National Bank of Indianapolis Parcel 3-Drainage Easement 107 N. Pennsylvania Street,Ste.600 Parcel Tax I.D. 29-13-05-001.103-034 Indianapolis,IN 46204 Total $203,000.00 ALL CHECKS LISTED'HEREON TO BE MAILED TO: • CrossRoad Engineers,PC Attn:Jill Newport • 3417 Sherman Drive • • Beech Grove,IN 46107- A-I ADMINISTRATIVE SETTLEMENT MEMORANDUM e4 �1 TO: Steve EngelIcing,Director of Administration OC� City of Carmel FROM: Stephen J. Klineman,Acquisition Specialist Specialized Land Services,Inc. DATE: July 16,2014 RE: Request for Administrative Settlement Project: Bridlebourne Drainage Parcel: 3 Owner(s): University High School of Indiana,Inc. We have pursued the attempted acquisition of the above subject parcel to the point where there is an impasse with the owners in regard to the amount of just compensation,as well as design issues. The City's"Fair Market Value"determination is$184,900.00. The owner has agreed to settle for$203,000.00 and will accept nothing less. We feel that it would be in the City's best interest to settle for the requested amount considering the cost involved in litigation, the risk of an even greater court award, and protection of the project schedule. We, therefore, recommend that the sum of$203,000.00 be awarded to the owners. The monetary amount represents an increase of $18,100.00 over the original offer and is the most practical and economical solution to this matter. THIS j OMMENDATION IS APPROVED: / ‘ 2D/ Lit Steve Engelkin_:,Director of dministration Date City of Carmel Prescribed by State Board of Accounts City Form No.201 (Rev 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL, INDIANA 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. Payee University High School of Indiana, Inc. AND NATIONAL BANK OF INDIANAPOLIS Purchase Order No. Attn: Mr. _John Kinman, VP I Terms 107 N. Pennsylvania St. , Ste. 600 1 Date Due Indianapolis, IN 46204 Invoice Invoice II, Description Date number I.1 (or note attached invoice(s) or bill(s)) Amount II PROJECT: Bridlebourne Drainage Improvements PARCEL: 3 COUNTY: Hamilton Compensation for acquisition of easement over 3.522 acres • ii 1.1 I" Total:I $203,000.00 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 charg is made were ordered and received except �-7 , 20 I ( . University High Schooll of Indiana,Inc. By: signature/ -I I r`1-1- Printed Name and tFitle By: Signature Printed Name and 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. , 20 Clerk-Treasurer Farm W®9 Request for Taxpayer 'Give Form to the (1=h0(.December 2011) requester.Do not ( D;padmentof the Treasury Identification Number and Certification end to the IRS. Inemal Revenue Service Name(as shown on your income tax return) University High School of Indiana, Inc, Business name/disregarded entity name,if different from above a a a c Check appropriate box for federal tax classification: w ❑ IndividuaVsole proprietor El C Corporation ❑ S Corporation ❑ Partnership ❑Trust/estate a� c a o ❑Exempt payee [I] Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P'partnership)► P L N ty ❑ Other(see instructions)► u Address(number,street,and apt.or suite no.) Requester's name and address(optional) n 2825 W.116th St, a City,state,and ZIP code ry m Carmel, IN 46032 List account number(s)here(optional) Kzal Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on the"Name"line J Social security number to avoid backup withholding.For Individuals,this is your social security number(SSN).However,for a resdent alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other - - en tities,it is your employer identification number(EIN).If you do not have a number,see How to get a _ Till on page 3. Note.If the account is in more than one name,see the chart on page 4 for guidelines on whose Employer identification number nu tuber to enter. Certification Un der penalties of perjury,I certify that: 1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me), and 2. I are not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding,and 3. lam a U.S.citizen or other U.S.person(defined below). Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply. For mortgage interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than interest and dividends, 'ou are not required to sign the certification,but you must provide your correct TIN.See the instructions on page 4. Sign. Signature of j Here U.S.person► / )/ "��� Date 7 /� General Instructions J Note.If a requester gives you a form other than Form W-9 to request your TIN,you must use the requester's form if it is substantially similar Seclon references are to the Internal Revenue Code unless otherwise to this Form VV-9. notet. Definition of a U.S.person.For federal tax purposes,you are Purpose of Form considered a U.S.person if you are: A person who is required to file an information return with the IRS must •An individual who is a U.S.citizen or U.S.resident alien, obtain your correct taxpayer identification number(TIN)to report,for •A partnership,corporation,company,or association created or exar-npie,income paid to you,real estate transactions,mortgage interest organized in the United States or under the laws of the United States, you paid,acquisition or abandonment of secured property,cancellation •An estate(other than a foreign estate),or of debt,or contributions you made to an IRA. Use W 9 only if you are a U.S,person(including a resident •A domestic trust(as defined in Regulations section 301.7701-7). alien] to provide your correct TIN to the person requesting it(the Special rules for partnerships. Partnerships that conduct a trade or requester)and,when applicable,to: business in the United States are generally required to pay a withholding tax on any foreign partners'share of income from such business. 1. Certify that the TIN you are giving is correct(or you are waiting for a Further,in certain cases where a Form W-9 has not been received,a num her to be issued), partnership is required to presume that a partner is a foreign person, 2. Certify that you are not subject to backup withholding,or and pay the withholding tax.Therefore,if you are a U.S.person that is a 3. Claim exemption from backup withholding if you are a U.S.exempt partner in a partnership conducting a trade or business in the United payer. If applicable,you are also certifying that as a U.S.person,your States,provide Form W-9 to the partnership to establish your U.S. allocable share of any partnership income from a U.S.trade or business status and avoid withholding on your share of partnership income. is not subject to the withholding tax on foreign partners'share of effecively connected income. Cat.No.10231X Form W-9(Rev.12-2011) Pao,e 4 Project: Bridlebourne Drainage Improvements Parcel: 3 If you decide to accept the offer of$1 84,900.00 *made by Hamilton County through the City of Carmel, sign your name below and mail this form to the address indicated above. An additional copy of this offer has been provided for your file. ACCEPTANCE OF OFFER I (We), 0. Lew,'s CJ's 'c vF , 0414 of I rt,.sI-ee land owner(s) of the above described easement or interest in easement, hereby accept the offer of $184,900.00* made by the County on this "I' h day of �S 1 , 20 " V . *Original Offer $184,900.00 Administrative Settlement $ 18,100.00 New Total $203,000.00 University High School of Indiana, Inc. By: By.;,„ 7 Signature Slg.nathre Y Gc( t-(,cJ, cft t Printed Name and Title Printed Name and Title NOTARY'S CERTIFICATE • STATE OF ZJDI HNA ) SS: COUNTY OF MIPR,i ON ) Subscribed and sworn to before me this clay of 0 U t-of , 20 /q My commission expires: l —as' 7-01 My county of residence is: .7`0 `7 N 50&) (Sign, tire) j;q caZUr L ' /N hgd i iN (Printed) Notary Public HAMILTON COUNTY, INDIANA 10108 STATEMENT OF THE BASIS FOR JUST COMPENSATION Code NA REV-29 1. This is a written statement of, and summary of the basis for, the establishment of the amount believed to be, through a valuation process,just compensation for the purchase of this permanent easement for drainage purposes. The amount set forth in Item 5 below is not less than the approved estimate of value. In accordance with Public Law 91-646 as amended,the"Uniform Act", and as codified in Indiana at IC 8-23-17-1 through 8-23-17-35, this value disregards any decrease or increase in fair market value of the property prior to the date of valuation caused by the public improvement for which the property is acquired other than physical deterioration within reasonable control of the owner. 2.The legal description of this acquisition is set forth in the instrument of conveyance in the following identified parcel and this acquisition is identified in the Acquiring Agency's records as: Des. # NA Parcel 3 Road 11e Street County Hamilton Owner(s) University High School of Indiana,Inc. 3.The area and type of interest being acquired: 3.522 acres permanent easement The amount in Item 5 below includes payment for the purchase of all interests in the real property and no separately held interest is being acquired separately in whole or part,except as may be explained in Item 8 below. 4.This acquisition is (Check one): a. ❑ A total acquisition of the real property. b. ® A partial acquisition of the real property. 5.The Agency's Offer: Just compensation has been determined to be and the Acquiring Agency's offer for the purchase of this real property is as follows: a.Total Land,Land Improvements and Buildings $ -0- b.Severance Damages(i.e.: Setback,Loss in Value to the Residues,etc) $ -0- c.Other Damages(Itemize) Cost-To-Cure estimates: $ -0- $ -0- Temporary RM/ $ -0- Total Damages S -0- d.Perpetual Easement $184,900.00 Total amount believed to be Just Compensation offered for this Acquisition is: $184,900.00 6. The amount in Item 5 above may include payment for the purchase of certain buildings and improvements and their ownership shall pass to the Acquiring Agency. These buildings and improvements are identified as follows: NONE 7.The amount in Item 5 above may include payment for the purchase of certain Land Improvements,Fixtures, Equipment, Machinery,Signs, Etc.,and their ownership shall pass to the Acquiring Agency. These items are identified as follows: NONE 8.Items owned by others (i.e.:lessee. tenants,etc.) included in Item 5 above are identified as follows: NONE 9.Remarks: NONE Hamilton County, Indiana Ap.roval:Cityof Carmel on behalf of Hamilton County Signature: t -, i Signature: Name Printed: C � ��11� Name Printed: Title: t. c -' / vv Company: Date: �`2�—(�2 Date: Prior Deed Reference: Instrument Number 200300123207 in the Recorder's Office Of Hamilton County, Indiana DRAINAGE EASEMENT THIS INDENTURE WITNESSETH: That University High School of Indiana, Inc., an Indiana nonprofit corporation (referred to herein as the "Grantor") for .good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, does hereby convey to the Board of Commissioners of Hamilton County, ("Grantee") and solely for purposes of the initial installation of the Improvements (as defined herein) to the City of Carmel, Indiana (the "City"), a non-exclusive perpetual easement through, upon, over, along and across the following described real property located in Hamilton County, Indiana, ("the Easement") to-wit; • See Exhibit A. The Easement is granted for the purpose of providing overland or subsurface paths and courses for the construction, maintenance, preservation of storm drainage, including but not limited to a detention basin and associated pipes, pumps and related drainage facilities (the "Improvements"). The Grantor reserves for themselves and their successors and assigns the right to use the Easement for any uses which are not inconsistent with the purposes herein. However, in the event the Grantor, or their successors, elect or desire to do any construction or alterations within the Easement; they shall do so only upon approval of the Grantee. The Grantor further agrees that they shall not grant any easements to any other utilities, or.other persons, through the Easement described herein, without the consent of the Grantee, and if said grants are given, those (/3353191.3 Page 1 or 5 C r easements shall be subject to the Grantee's rights to regulate and permit construction or alteration with the Easement. The Easement shall include temporary access over Grantor's Real Estate as shown on Exhibit B for the City to access the Easement and install the Improvements-. The City shall promptly repair any damage to Grantor's real estate caused by the City in accessing or installing the Easement and Improvements. The Easement shall also include temporary access over Grantor's existing driveways and parking areas for Grantee to access the Easement and to maintain the, Improvements. Grantee shall temporarily use such existing driveways and access areas as may exist on the date hereof or as may be relocated from time to time in the future to the extent practicable and Grantee shall promptly repair any damage to Grantor's real estate caused by Grantee in accessing or.using the Easement and.Improvements. The City will install the Improvements as shown on Exhibit C. Upon,completion of the Improvements, the City will restore the Grantor's real estate to as near as practical to the condition that existed prior to installation of the Improvements. Grantor shall be responsible for mowing the Easement and the detention basin except that Grantee shall maintain the Improvements, including but not limited to, associated pipes, pumps and related drainage facilities that are part of the Improvements. The.Grantee, its employees, or contractors shall not be,liable to Grantor; or his successor in title, for any improvements to the real estate, landscaping, sod, or any other improvements within the Easement, the installation and maintenance of the Improvements excepted, which are damaged in the course of the 'installation and repair of the Improvements contained in the Easement. Notwithstanding the preceding sentence, in the event the Grantee, its employees, or contractors are required to come upon the Easement to replace, restore, or clear any drainage structures, ditches, drains, or swales contained therein, the Grantee shall only be liable to restore I/3353191.3 � i--- Pagc 2 of 5 the Easement to its previous grade, and to re-seed and undertake erosion control measures as are required by 327 IAC15-5 as amended, the installation and maintenance of the Improvements excepted. To the fullest extent permitted by applicable law, Grantee shall indemnify, defend and hold. Grantor and all third parties to which Grantor grants rights with respect to Grantor's real estate harmless from and against any and all injuries, liabilities, losses, damages, costs, and expenses of every kind and nature (including but not limited to reasonable attorneys' fees) incurred by such party and arising from or in connection with (i) any activity of the City or Grantee, their respective employees, agents or contractors in, on, or about Grantor's real estate or the exercise by the City or Grantee of any of their rights hereunder, except to the extent caused solely and directly by the negligence or intentional misconduct of Grantor, and (ii) any liens filed against Grantor's real estate or claims or demands made against Grantor or Grantor's real estate for work performed by or on the behalf of the City or Grantee.. Prior to the City or Grantee, their agents or contractors, entering upon Grantor's real estate and the Easement, Grantee shall furnish to Grantor proof of insurance in form and amounts reasonably acceptable to Grantor. During all periods in which the City or Grantee, their agents or contractors, are on the Easement, Gr antee shall maintain such insurance, or cause such insurance to be maintained by its agents or contractors, in full force and effect. Such insurance (other than Worker's Compensation and Employer's Liability) shall name Grantor as an additional insured and shall not be canceled, modified, limited or allowed to expire without thirty (30) days prior written notice to Grantor. At a minimum, such insurance shall include the following: (a) Worker's Compensation Insurance in an amount no less than required under Indiana law and Employer's Liability Coverage Insurance in an amount no less than Five 1/3353191.3 Page 3 a 5 O "' 1-Iundred Thousand Dollars ($500,000); (b) Comprehensive Automotive Liability Insurance in an amount no less than One Million Dollars ($1,000,000) combined single limit; and. (c) Commercial General Liability Insurance in an amount no less than One Million Dollars ($.1,000,000) per occurrence. Grantor agrees that, at Grantee's discretion, the Easement and the Improvements may become part of a legal drain system and if so, Grantor shall not violate applicable laws, ordinances;rules and regulations relating to such legal drain system. This Drainage Easement and the agreements herein shall run with the land and shall be binding upon and inure to the benefit of the Grantor and its successors and assigns and upon the Grantee and its successors. Grantee hereby accepts the Easement herein granted in its "AS-IS, WHERE-IS" condition, with all faults and without any representation or warranty of any kind, express or implied, by Grantor. The Easement herein granted is made subject to all covenants, conditions, restrictions, encumbrances, easements and other matters of record as of the date hereof, except Grantor shall obtain, using the proceeds of compensation payable to Grantor, a partial release of the mortgage lien on Grantor's real estate from The National Bank of Indianapolis, which partial release shall cover the Easement. The City agrees that it will not exercise its rights under the Easement until such time as payment to Grantor..has been approved by the appropriate municipal bodies. The City will notify Grantor'of such approval prior to commencing work under this Easement. [Signature page follows] 1/3353191.3 Page4of5 © P� IN WITNESS WHEREOF, The Grantor has executed this Drainage Easement on this Ig_ yof A , 20 1`{ . GRANTOR University High School of Indiana, Inc. ',I Ffi'.ei CD cam,is (Jta--t, 13 -- a Print name Ind title t a STATE OF INDIANA ) ) SS: COUNTY OF HAMILTON ) /Mrvccc,� tC Before me, `a Notary Public this /(p day of Gies , 20 iq personally appeared the within named Je.e4Y'E Le- 1J/. and acknowledged the execution of the foregoing document. WITNESS my hand and official seal. Notary Public, Residing in.1 ikon County, IN /-/Cc ii Cc:Ct. My Commission Expires: This instrument prepared by Tammy K. Haney, Keller Macaluso LLC, 760 3rd Ave, Suite 210, Carmel, Indiana 46032, (317) 660-3400. I affirm, under the penalties for perjury, that I have taken reasonable care to redact each Social Security number in this document, unless required by law. Tammy K. Haney. 1/3353191.3 Page 5 01'5 C 0 P EXHIBIT A • / il89'3_51`E- 162.99j a `N.W.-COR, NW 1/4 SEC. 5, T�7N, 03E N Y it 711 H ° F SCALE: 1"= 200' e "' pi t m ° d UNIVERSITY HIGH SCHOOL I'' v�o OF INDIANA,INC. edsl I Wow WARRANTY.DEED Y:1 # INST X200300123207 In YQ g \ 12 O s 1-L7 a -R Y`17. �W_ �\` S • p�A1 L I. 1' ig 11 'I I -T o 1 J 1 ..• 1 It.11-OF BEGINNING • a.Q�ry� I N9040'01"E - 560.31' �.t DRAINAGE EASEMENT �p f INS7X200B00071207 10 1D UttA��t At EMS E/NI � ' s DaT. 4 13 acv I 3.522.ACRES +/ t^ 500'02'09'E• d �' 1 1-�pp.T.1.5 p/ ..! '2218' • •`a' Rt.LEBOU RUE SEC. SANITAR4"SEYIEri9*- 717.°5 BRIDLES E SEC. 5 i . a.P.C. I, SLIDE 208 EASEMENT.AGREEMENT_^____P.C. 1, SU DE 134 _ 7Afl98D lL094067 'I T- Yi f'1--- r 5 1 ` b __�• l_f.. r' rt'---- `i'�., t, err I' `,1 1 rl r 1 1 r 1 I 9. 4 5 8 7 �yt.l 8 9 .'`fri ei'r' ' I �/ ��. .. err a m 0 o Denim;e Easement o Through the Property of • Timrerut'.Hi;h Sehool of Indiana,Inc. ', Weiinnty Deed TI1 tsto cent,N'asaber:003001'33107) Put of the Nort6aet Quitter of Section 5.Township 17 North,Rasp 3 East Hamilton County Indiana desarbed as • pfolows; El com at the Nottltwet Comer of said Nathwo Quvoer,thenee North 39 degrees 35 rmmnc 51 wench East sd (assumed hewing)136299 feet along the Noeth.Iine ofaaid Northw+st Quuaer to the Enut Line of Lal.•-ym'Phase 1. recorded iii Plat Cabinet 1,Slide-13 in the Office of.the Remain of Hamilton Cormty,Ethane,thence South 00 degrees o .01 tamuIo 15 second,Wen 1065.08'tett along said Eati tine to the POD(T OF BEGINNING.of t♦:is;drgiytioa thence id `forth90 degrees 00 mrmtees 00,eccods•Ea t 560.31'feel ride weseern lore of a Drainage Fe... ,.e:wnt recorded as. I latilth®t 14o:100600071267 in Mid Offce of the Reeaden thence South'36 degree:50 minutes 23 seconch Fmt 5' 261 10 feet along said western lit,thence South 00 deg*.:02 minute;09 secot,ls East 22.16 feet to the North line of a Bridiebosene Section 5 eecutded m Plat Cabinet 1,Slide 134'.in said Office of the Reeoeder,Reece Solidi S5rdegeees 05 • S nineteen 09 tecond;•1 nit 717.06'feet along the Narib Lire of said Bridlebomne Section 5-and Section 6 recalled in Plat Cabinet 1,Slide 208.in said Office of the Recorder to the East Line of said Larkspur Phase 1;thence North 00 degrees 01 f nvoates 15 seenads East 24256 feet along,aid Eat Lice to the Point of Begin®g,ciuutiioiug 3322 actin mac of lest. 0 r- B y . 7. RpABNAC =ASEIWEN r ez AM[RICAIe 7200 SWl0E1N�STATION DATE:tb-.20-12 St1EEr 110. 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OPY 1/3353191.3 Page 8 01'5 SALES DISCLOSURE FORM d --°_` 4 State Form 46021(810/10-09) ( I I ;,('7;:c- a SDF ID l 3i"�'qs.'_"' Prescribed by Department of Local Government Finance County Year Unique ID °W''-, ' ' Pursuant to IC 6-1.1-5.5 "4\4;:.41.^17f_ GET COUNTED IN 20101 LEARN MORE AT WWW.CENSUS.INDIANAEDU SDF Date: '/Of°• PRIVACY NOTICE:The telephone numbers and Social Security numbers of the parties on this form are confidential according to IC 6-1.1-5.5-3(d). a T r s a a G. Y■fa e "r n nr r ld� ;:1"' 3 ,ARQP-tact 1pirea . USER%VSOV AVCIsl~LLEF M:1 aR..ti -�, v �'',2taW "-A5 �" r � r'34/ r�7 -4t a:i4.. z::.._ !- t.�_ F �)l:i 4:u �.•._-. `S -,a..�ti.-ru4?':e.��..rs6r• t-^'_. L�-�=� L�pf,':� assns L�-Y- ;6s�'cLt-`c•'y+`�"l� al r�.�.S+e i a 7ri,�`. s V £A PR Narrik°I?RANSF-.,. -`DD t'''11 .-1-",OWN EYED 0-43Ai�fNGi,-17 ,-J.:.1, IYCErDO UNI.:,..V=?� _d{�rd 4,; „i. . _ ' #L';T ,to 1.Property Number Check box lf applicable to 5.Complete Address of Property 6.Complete TUXBIIPDi9 Address(If different from parcel property address) I Al 29-1 3-15-000-001.103-034 ❑ 2.Split Approx. 2845 W. 116th St. One Hamilton County Square j Fi 3.Land Carmel, IN 46032 Carmel, IN 46060 ❑ 4.Improvement i 7.Legal.Desrfptlon of Parcel A: I Pt NW4 5-17N-3E B.) ❑ 2.Split ❑ 3.Land ❑ 4.Improvement 7.Legal O esdptlon of Parcel B: 0-tr I�1DIf10,617A TWI :,rAL TH=A ?�A�PPL'Y,-)=`it4� :'ar LNY:LES D'ETA` ISC 0`4 Lv O 0V1 'I T :t _X4. e-g-', v ,41 r: xr:1.-��-,:-,.,_-',2� .,gi.; �t era �� ��s -w...:,91 c� 4:i"A:. OY ->•V•_�5� r;,a .._ � S.L S ED INS 16 Itlin s ict::. %t kw".x : :•,-Y'"� -L1u E f,1-d4axi:�'aig t�t)p -.. `I, ivt§tI _�A,4,..z I Y__ _ i iiFt gnu :4_1 r,.w,y4` ;e tut i :a.;:`��.t+y _., n:.:M<..i�.-,_:�.xr .t,��,-c s ,� =:,r an ,.v..r?,T�..z.-x _d_., � � ,-�y -r . .. _._._,..a�r*f-cfs:.r:x "'�.A:3 ......i,'��S_iry c�If conditl o n lapplles,filer Is subject to disclosure and a disclosure filing fee. I '' 0 1/1(0 ad yes NO CONDITION 1 1.Conveyance date(.uM,'aoi YY): Y GI n 1.A transfer of real property interest for valuable i 2.Total number of parcels: 1 consideration. ! 3.Describe any unusual or special circumstances related to this El n 2.Buyer is an adjacent property owner. sale,including the specification of any less-than-complete is El 3.Vacant land. ownership interest and terms of seller financing. nr-,.71 4.Exchange for other real property("Trade"). I .sement over 3 522 acres of land LQ 5.Seller paid points.(Pracide the'sloe TobieCitem 12.) NI n 6.Change planned in the primary use of the property?(Describe in special circumstances In Table C Item 3.) ri 1✓[ 7.Existence of family or business relationship between buyer and seller.(complete Table C Item 4.) ri I ,/1 8.Land contract. Contract term Va: and contract date(M,1/DD/Y11v): 0 151 9.Personal property included in transfer.(Provide the value YES NO CONDITION Table C Item 5) El ,/ 10.Physical changes to property between March 1 n I-4 l 4.Family or business relationship existing between and date of sale.(Describe In special circumstances In Table Cftern 3.) ' buyer and seller? [ I Amount of discount: $ 0.00 11.Partial interest.(Describe in special circumstances in Table C Item 3.) Disclose actual value in money,property,a service,an agreernen I,or other consideration. ri ✓ 12.Easements or right-of-way grants. If conditions 12•IS apply,filers are subject to disclosure,but no disclosure filing fee. 5.Estimated value of personal property: $ 0.00 YES MO CONDITION 6.Sales price: $ 03._600.00 0 I I 13.Document for compulsory transactions as a YES NO CONDITION result of foreclosure or express threat of n RI 7.Is the seller financing sale? If yes,answer foreclosure,divorce,court order,judgment, , questions(8-13). condemnation,or probate. ,/] 14.Documents involving the partition of land n 0 8. Is buyer/borrower personally liable for loan? between tenants in common,joint tenants,or n ✓I 9. Is this a mortgage loan? tenants by the entirety. 10.Amount of loan: $ 0.00 I✓I I [ 15.Transfer to a charity, not-for-profit organization, 11.Interest rate: 0.00 /D D or government. - 12.Amount in points: S 0.00 13.Amortization period: I NA INDIANA SALES DISCLOSURE F OR M SDF ID: .. Ya inn�4 k kqlaWi i x' ..3 SR � k 2 f' " f,e .to, ?�1,rg` e -vz �y i� � ? W3 - _�_ ,�yz I •. t+1 .:v _Yk. z,• r”..z .R A„_ _ j Hrde--r, ,N , -..-�e�r t. .._,. ._r .tom_. r-_w,x, . •iy.. .. r �. ?: '4> Stephen J. Klineman President iPropesrer oldie Soles Disclosure Form Title 630 Ill.P,ange!ine Rd.. Ste. C Specialized Land Services. Inc. ■ Address(Number and Street) Company ' Carrnel,IN 46032 317-218-0583 sklineman @msn.com ' City,State,and ZIP Code Telephone Number E-mail 'ID7^I�+ h y.pie; � �J"L.3f-t 7' R-.....,,_�-tu J- r.µ�%`-,"�,,; ,�� tG ti S�- - •¢ 'r`i � of �+v r s ,;, t � E.!r.01�J��, gika L���.nvw'~U7,'_,i;R4 i. :.—: �r w. a3.;� li 45 1 yam, a 7 1u ,.trt is� y� :ee5- 3 ``a—W Y `�-.i ,: "PJ_t-..+kit bkn rte,.....a ._:r.�,:, rw-..�.a-;:v-°'i-r..�„ d_ c. .y�x'n:.� zt`�-r._ ?:�+'�s.. :.�.Y=. i,y� �` +�z; I lniversilyHigb School of Indiana Inc Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document , 2875 'N 116th St • Addrers(Number and Street) Address(Number and Street) Carmel.IN 45.032 City,State,and ZIP Code City,State,and ZIP Code 317-733-4475 Telephone Number E-mail Telephone Number E-mail Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete as re uir a}v,ancLirs prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". r ` � i�� ' Signa tare afSeft�( L / /� Signature of Seller J -( 1 r Lj(f,', Fr c (l (/l PrintedName of Seller _Si i n Date(NN/DD r, Printed Name o Seller Si•n Date(NN/DD/YYYY) 1 F;B>JY, lfNVAG1�A IT ,E(S'ur,APP;L�j,CA,TI;QN •O,I2 I OPER'_P_ ,•T/�3C�DED�IC fOTJS„[a I rTT ACC308:MS,1'I ATrAPPLY in<< arri, Hamil-tn County NA Buyer 2-'lame as appears on conveyance document Buyer 2-Name as appears on conveyance document One Hamilton County Square Address(Number and Street) Address(Number and Street) Noblev:ille,IN 46060 City,Sta?,and ZIP Code City,State,and ZIP Code 317-2'13-0583 TelephoteNumber E-mail Telephone Number E-mail THE SALESDISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES Ito CONDITION YES NO CONDITION Ei Q 1.Will this property be the buyer's primary El 0 3.Homestead residence? Provide complete address of primary MI 4.Solar Energy Heating/Cooling System residence,including county: r- 5.Wind Power Device One Hamilton County SqlfarP r Address Nutnberand Street) f l SI 6.Hydroelectric Power Device Noblesiille, IN 46060 Hamilton El Q 7.Geothermal Energy Heating/Cooling Device City,Sta a ZIP Code County ' D j 2.Does the buyer have a homestead in Indiana to be n C 8.1s this property a residential rental property? vacated for this residence? If yes,provide _ 171 9.Would you like to receive tax statements for this complete address of residence being vacated, property via e-mail?(Provide contact information including county: below.Please see instructions for more information. Not available in all counties.) Address(Aumber and Street) City,Sta c&71P Code County I Primary property owner contact name E-mail Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". (Note: ipouse ii formation Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is icing fried.) Signature y Buyerl Signature of Buyer2/Spouse iLphPn J Klineman Agent tOLJ iamiltoa Gn■lnty 03//2 /10 r Y Printed Leal Name of Buyer 1 Sign Date(,NSt/DD/rrly) Printed Legal Name of Buyer 2/Spouse Sign Date(v:!t/DO/-rr,-r7 I Lost 5 dig's of Buyer 1 Driver's State Last 5 Digits of Social Security Number Last 5 digits of Buyer 2/Spouse Driver's State Last 5 Digits of Social Security License/El/OtherNumber Number License/iD/Other Number INDIANA SALES DISCLOSURE FORM SDF ID: Page 3 T ,•t .��}�I,.,,v�Ar (.� [.�•,(� r�.�'1�Zf J�+s._,; zi.:s-;.r:,,•^. �r -+--un. t _.+ �r-• t t,�{ i, �T rlv' �-- r +!VAIT2T 0 lYijl NO.0 �I�i�.1L.%`.«4u.-{.-��.y't,...fJ'�-I � ; �yt �`'�r.iY'�c'� .�? .9'4 1� -✓4•i4, IR:1,44 ��r�s�_r--M _li -err a y''4 r mug -^ _ — - —- "- �. .. _ a...+�4.cat�_i..�'li :d:.:,-_s.� _ ,. ... .�_.,.- ...4.,�-_ ._�.l:,ys;',_3cr� The county assessor must verify and complete items 1 through 14 and stamp the sales disclosure form before sending to the auditor: 1.Property 2.AV Land 3.AV Improvement 4.Value of Personal 5.AV Total 6.Property 7.Neighborhood 8,Tvx District 9.Acreage Propery Class Code Code A.) a.) Assessor Stamp 10.Identify physical changes to property between March land YES 1 NO CONDITION date of sale. ❑ ❑ 11.1 s form completed? ❑ ❑ 12.State sales fee required? 13.Date of sale GM.a/DD/rvrr): 14.Date form received(•a,N/DD/yrrr): Itemsa5 throu;Ii ig are lobe coin leted'b the assessor when valldatlri th.s sale:.. 15 If applicable identify any additional special circumstances relating,to•validation of sale CO DITION ❑ ';16'S alevaliid for trending?• ❑ -.17 Validation of sale complete? • d,by ' •:. 18:Validate ` P: RT�3 rCOUN`�Y'"AUDI COR xlv >x f n P r �?i •....... �S.._�. �..__ .. . ......... Z, L_'..�m f..;?.G. .. —^1�l F1.1.�!%P?F'_.7.f.-•.1.�-. T :,'n'ta_'�"�*1. T' Lam.. .. _�.._..�v{S:L�. :.SS.- •iRtgK ��•�-__ -ti.gi Auditor Stamp 1.Disclosure fee amount collected:$ YES NO CONDITION 2.Other Local Fee: $ ❑ ❑ 6.Is form completed? • 3.Total Fee Collected:$ ❑ ❑ 7.Is state fee collected? ❑ ❑ h Att 8.Attachments complete? 4.Auditor receipt book number: 5.Date of transfer(.NSi/DO/rrrt3: _�.;....t; -.. -�--s- r:r}{;. PQ'f2T.4=,.;f188EIE'[1FOF;STATE10SI QF gfiRdt;OT�J;,OTrASSE5$$Dai%fli T1T101 - . ..af1gNi t 4 gisa.:zJ! :::.: ",_A: F r„,s _,tTs'i{; SDF ID SDF Date(o-t:u/DO/rrm Buyer I-Name as appears on conveyance document Parcel/lumber Address of Property(Number and Street) Check all that apply: EiCity,State,and ZIP Code of Property Homestead ❑Solar Energy ❑ Wind Power Hydroelectric 0 Geothermal 0 Rental Property Auditor Signature Date(MsI/OV/ryYY) [1 Electronic Statement(e-mail) A person who knowingly and intentionally falsifies value of transferred real property,or omits or falsifies any information required to be provided in the sales disclosure forrn commits a Class C felony r o N89'35'51"E — 1362.99j z ir N.W, COR., NW 1/4 w SEC. 5, T17N, R3E In a LA _ W z o z a a z lo R ° •• SCALE: 1" = 200' 0 LUz T.< o �L UNIVERSITY HIGH SCHOOL IA o OF INDIANA, INC. N I 3 i f- WARRANTY DEED o LA< INST #200300123207 in I-O N }.Z O O QWo •N 12 O QQH& O VI ■ --- 05/ VI 0 w Z . oo Q��N') .\ . in D O 1 O 1 \O h0�� - 1° I q "", cp 11 1 I1 \\ i I J I ,t5 '.• ,� 1 /-P011`{T OF BEGINNING `. w �PQ•�� 1 N90'00'00"E - 560.31' • \` DRAINAGE EASEMENT > z 10 w �� /////////// \S� INST200600071267 I _ I /// / / `36j`SO- z - RAINAGE EASEMENT 1pr'�, • 9 °OCV 1 3.522 ACRES +/— F S00'02'09"E ° Z ( I // // �i. _—---. - 1- ` `,BRIDLEBOURNE SEC. 6 SANITAJBSEFlER 9 N!'— 717.06' BRIDLEBOURNE SEC. 5 o �' . P.C. 1, SLIDE 208 EASEMENT AGREEMENT _____— P.C. 1, SLIDE 134 INST#20070094067 N - 1 -1 FI 1-I --. `, , . I I I I I \ 1 I -I I I 11 1 1 I 1 1 I ' /' / tz 11 1 1 I I / I t 1/// / . 0 4 1 II 5 6 7 1,1 8 1 1 9 , / I L 1 / r . 1 // / 1 1 / // ./ /• /. Q � . I ., /'/.i ., ,/ ce O 0 Drainage Easement o Through the Property of • = University-High School of Indiana,Inc. - z Warranty Deed(Instrument Number 200300123207) z m Part of the Northwest Quarter of Section 5,Township 17 North,Range 3 East Hamilton County Indiana described as 0 follows: o . • `' Commencing at the Northwest Corner of said Northwest Quarter;thence North 89 degrees 35 minutes 51 seconds.East • Q (assumed bearing)1362.99 feet along the North Line of said Northwest Quarter to the East Line of Larkspur Phase 1 recorded in Plat Cabinet 1,Slide 13 in the Office of the Recorder of Hamilton County,Indiana;thence South 00 degrees . Si- '4. 01 minutes 15 seconds West 1065.08 feet along said East Line to the POINT OF BEGINNING of this description;thence a' North 90 degrees 00 minutes 00 seconds East 560.31 feet to the western-line of a Drainage Easement recorded as I Instrument No.200600071267 in said Office of the Recorder;thence South 36 degrees 50 minutes 23 seconds East N 261.10 feet along said western line;thence South 00 degrees 02 minutes 09 seconds East 22.16 feet to the.North Line'of NBridleboume Section 5 recorded in Plat Cabinet 1,Slide 134 in said Office of the Recorder;thence South 89 degrees 05 minutes 09 seconds West 717.06 feet along the North Line of said Bridleboume Section 5 and Section 6 recorded in Plat Cabinet 1,Slide 208 in said Office of the Recorder to the East Line of said Larkspur Phase 1;thence North 00 degrees 01 minutes 15 seconds East 242.56 feet along said East Line to the Point of Beginning,containing 3.522 acres more or less. a 0 . o . w • DRAINA GE EASEMENT w ' • J U AMERICAN 7260SHADELANDSTATION DATE: C)5-20-12 SHEET NO. to 5D4I7AN55A8P0 OLFIS A,,<.1 1476.25456 3-.0329750 7 t STRUCTUREPOINT TEL 317IN. • W BY: JNH O of d INC. w."AV.structurepoint.com • JOB NO. 201100507