250733 10/21/15 CITY OF CARMEL, INDIANA VENDOR: 367514
® ONE CIVIC SQUARE JBM CONTRACTORS CORP CHECK AMOUNT: $***353,057.00*
,? CARMEL, INDIANA 46032 5299 W OLD 106TH ST CHECK NUMBER: 250733
+wtlo ZIONSVILLE IN 46077 CHECK DATE: 10/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 4460807 32956 2 353,057.00 PALLADIUM LANDSCAPING
Document G732 - 2009
Application and Certificate for Payment,Construction Manager as Adviser Edition
TO(OWNER): City of Carmel Redevelopment Commission PROJECT:The Palladium at the Center for the Performing Arta APPL NO.: 2 DISTRIBUTION TO:
30 West Main Street,Suite 220 Landscape Package OWNER
Carmel,IN 46032 PERIOD TO: 9/30/2015 CONSTRUCTION MANAGER
CONTRACT DATE: ARCHITECT
FROM(CONTRACTOR): IBM Contractors Corp VIA(CONSTRUCTION MANAGER):Shiel Sexton PROJECT NO.S: CONTRACTOR
5299 W.Old 106th Street 902 North Capitol Avenue FIELD
Zionsville,IN 46077 Indianapolis,IN 46204 OTHER
CONTRACT FOR: Landscape Package VIA(ARCHITECT):CSO Architects
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that tothe best ofthe Contractor's knowledge.Information
Application Is made for Payment,as shown below,in connection with the Contract. and belief the Work covered by this Appl tion for Payment has been completed In accordance
Continuation Sheet,AIA Document G703,is attached. with the Contract Documents,that al unts have aid by t tractor for Work which
previous Certifications for Paymen er • u d ants Ived om the Owner,and that
L ORIGINAL CONTRACT SUM..........................«...-.___............................»..... $ 1,243,000 current payme own rel no ue.
2.NET CHANGES INTHE WORK_.............___..............«.___.........._._......... $ 0 CONTRACTOR: 'UZ-7
Ll
�
3.CONTRACT SUM TO DATE(Una 1+2)__.......»«....__.«...._......_._...._..........._ $ 1,243,000 BY: ATE:
......... $ 748,050 =JOHN
4.TOTAL COMPLETED&STORED TO DATE,..«.__.......___»..............._._.(ColumnGon G703) State County: IndianaENSERGCounty of: Boone5.RETAINAGE: Subscribed and sworn to beforet/a. 10.0% of Completed Work me this plt�nn(Dolumn D+E on G703) $ 62,150 b. 10.0% of Stored Material Notary Public b.22,2020
(Column F on G703) $ 0 My Commi Ion expires:
Total Retainage(Line 5a+5b or Total in Column I of G703)............................... $ 62,150 CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents,based on on-site observations and the data comprising
6.TOTAL EARNED LESS RETAINAGE.............__.........«,.._....«..._...........»........... $ 685,900 this application,the Construction Manager and Architect certify to the Owner that to the best of their
(Line 4less line 5 Total) knowledge,information and belief the Work has progressed as Indicated,the quality of the Work Is in
accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT
7.LESS PREVIOUS CERTIFICATES FOR PAYMENT.............___............................... $ 332,843 CERTIFIED.
(Line 6 from prior Certificate)
8.CURRENT PAYMENT DUE...................___......._.____............._...................... $ 353,057 AMOUNT CERTIFIED......................................_.._...................................... $ 353,057
(Attach explanation Uamount certified differs from the amount applied for.Initial
9.BALANCE TO FINISH,INCLUDING RETAINAGE off figures on this Application and on the Continuation Sheet that are changed to
conform to the amount terrified.)
(Line 3 less Line 5) $ 557,100
CONSTRUCTION MANAGER: Shlel Sexton
By: Date:
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS
Total charges approved In ARCHITECT: CSO Architects
previous months by Owner $ $
Total approved this month $ 0.00 $ By: Date:
TOTALS $ 0.001 S 0.00
NET CHANGES by Change Order $ 0.00 This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractor named
herein.Issuance,payment and acceptance of payment are without prejudice to any rights f the Owner
or Contractorunderthe Contract.
AIA DOCUMENT G732-2009(formerly G702 Cma-1992)APPLICATION AND CERTIFICATE FOR PAYMENT•CONSTRUCTON MANAGER-ADVISER EDITION
1992 EDITION'1992`AIA 1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,N.W.,WASHINGTON,
D.C.2006.5292
Page 2 of 2
CONTINUATION SHEET AIA DOCUMENT G703
AIA Document G702,APPLICATION AND CERTIFICATE FOR PAYMENT,containing APPLICATION NO.: 2
Contractor's signed Certification is attached. APPLICATION DATE: 9/30/15
In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 9/30/15
Use Column I on Contracts where variable retainage for line Items may apply. PROJECT NO.S: 0
A B C D E F G H I
SCHEDULED WORK MATERIALS TOTAL
VALUE COMPLETED PRESENTLY COMPLETED
FROM PREVIOUS STORED ANDSTORED BALANCE
ITEM DESCRIPTION OF ESTIMATED APPLICATION (NOT IN TO DATE % TO FIN 15H 10.0%
NO. WORK COST (D+E) THIS PERIOD D OR E) (D+E+F) (G:C) (C-G) RETAINAGE
1 Supervision $ 42,000 10,500 10,500 0 21,000 50% 21,000 0
2 Bonds $ 18,100 18,100 0 0 18,100 100% 0 0
3 Contingency Allowance $ 50,000 0 0 0 0 0% 50,000 0
4 Mobilization $ 1,000 1,000 0 0 1,000 100% 0 0
5 Demobilization $ 1,000 0 0 0 0 0% 1,000 0
6 Insurance/Hazcom/Safety $ 2,500 2,500 0 0 2,500 100% 0 0
7 Submittals $ 7,500 3,750 3,750 0 7,500 100% 0 0
8 Field Engineering $ 10,000 10,000 0 0 10,000 100% 0 0
9 Closeout $ 5,000 0 0 0 0 0% 5,000 0
10 Misc.General Conditions $ 30,900 7,725 7,725 0 15,450 50% 15,450 0
11 Temporary Walk Protection $ 28,000 20,000 0 0 20,000 71% 8,000 0
12 Temporary Fence $ 10,000 10,000 _ 0 0 10,000 100% 0 0
>•'=i tWr! Tc .�,..i' ; t� '�'.c•„d:�'a%4' .n'.`.'a. - 'r :i;-'.':-•-. '�i'�"'.^e%^�-._?:..".,.-�-,;, ..4 s;r;":7;f_]':~:
'a`.,.i^3_:,.:..Construetio ,F�>-z�- _ .�::, ;: s; •S;T-. �,... a...r.rM� n^r:�"�: - gx�>:_,>.>,M.� ;�5
...._.._. :: �...� . . ��.:�._.:aiFz�4.> ..t�:. .. ....f�•:�e��.:�<.,.��. 4. res. ;R� fisb��.0 .^� ,'N'S .' �E,%)�`' � +::::..:........
14 Strip Sod $ 15,000 0..........................._...........-..0..._. 0.., 0 0% 15,000 0
15 Subsurface Drains $ 25,000 0 0 0 0 0% 25,000 0
16 Concrete Foundations $ 165,000 123,750 41,250 0 165,000 100% 0 0
17 Masonry $ 305,000 10,000 250,000 0 260,000 85% 45,000 0
18 Metal Fabrications $ 15,000 0 0 10,000 10,000 67% 5,000 0
19 Cast Iran Urns $ 160,000 80,000 0 0 80,000 50% 80,000 0
20 Waterproofing $ 30,000 0 0 0 0 0% 30,000 0
21 Joint Sealants $ 12,000 0 0 0 0 0% 12,000 0
22 Plant Plumbing System $ 50,000 37,500 10,000 0 47,500 95% 2,500 0
23 Electrical $ 120,000 30,000 40,000 0 70,000 58% 50,000 0
24 Irrigation $ 40,000 5,000 5,000 0 10,OOD 25% 30,000 0
25 Landscaping $ 100,000 0 0 0 0 0% 100,000 0
26 0 0 0 0 #DIV/01 0 0
27 0 0 0 0 #DIV/01 0 0
28 0 0 0 0 #DIV/01 0 0
29 0 0 0 0 #DIV/01 0 0
30 0 0 0 0 #DIV/01 0 0
31 0 0 0 0 #DIV/01 0 0
32 0 0 0 0 #DIV/Ol 0 0
33 0 0 0 0 #DIV/01 0 0
34 0 0 0 0 #DIV/01 0 62,150
35
1,243,000 369,8251 368,225 10,000 748,050 60.2% 494,950 62,150
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
G703-1992
AIA DOCUMENTG703 APPLICATION AND CERTIFICATE FOR PAYMENT 1992 EDITION AIA 1992
THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,N.W.,WASHINGTON,D.C. 2006-5292 G703-1992
fill.
BM:C PI.QX.-TOPK CUP.
PARTIAL CONDITIONAL WAIVER OF LIEN
WHEREAS, JBM Contractors Corp has pursuant to an agreement with City of Carmel
Redevelopment Commission furnished certain materials,equipment, services, and/or labor for the project known as
The Palladium at the Center for the Performing Arts—Landscape Package located at One
Center Green,Carmel,IN 46032 ;
WHEREAS,the undersigned is duly authorized to execute this Partial Conditional Waiver of Lien for and
on behalf of the subcontractor/supplier;
I
NOW,THEREFORE, JBM Contractors Corp upon receipt of the sum of $353,057 waives
and releases any and all liens or rights of liens, bond claims or statutory rights against the`Tenant, Contractor,
Subcontractor,any and all Owners of any title or interest in the real estate upon which the Project is situated(Owner),
the Project and the improvements located thereon or any right against any labor and/or material payment bond it has
or may have on account of any and all materials,equipment,services,and/or labor furnished for or in connection with
the Project through the date of 9/30/2015 ,represents and warrants to Tenant, Contractor, Subcontractor
and Owner that no other person or party has any right to a lien or claim on account of any materials, equipment,
services, and/or labor furnished on or before the Current Date by, to or through the Contractor, and agrees to
indemnify,defend,and hold the Tenant,Contractor,Subcontractor and Owner harmless from and against any and all
liabilities,losses,costs,expenses,including attorney fees,by reason of claims or liens for any materials,equipment,
services, and/or labor furnished for or in connection with the Project prior to the Current Date by,through or to the
Contractor including but not limited to claims or liens by the Contractor's subcontractors,whatever tier,suppliers,or
equipment lessors.
JBM Contractors Corp acknowledges that this Partial Conditional Waiver of Lien is given to
induce the payment recited above, and that upon receipt of the Current Payment by the Contractor, this Partial
Conditional Waiver of Lien becomes valid,enforceable and of full effect, may be recorded.
JBM Contractor C
N b n cto
Au orized Representative
Senior Project Manager/Estimator
Title
10/07/2015
Date
STATE OF Indiana )
SS:
COUNTY OF Boone )
Before me,a Notary Public in and for said County and State,personally appeared Keith Cochrun who
acknowledged the execution of the foregoing Partial Conditional Waiver of Lien,and who,having been sworn,stated
that the requirements therein contained are true. ,!
Witness my hand and Notarial Seal this 7 day of ����( 20 ~
My Commission ires:
JOHN STUERENBERG inted: Michael Stuerenberg
otary Pu lic SEAL
Notary Public,State of Indiana
My commission Expires Feb.22,2020
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.
1 Payee
Cotj�r&AT5 COrp. Purchase Order No.
52 q �. ��� 101+�' Sf Terms
Z1, -nailte IN x-6077 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
3 9 zo
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and 1 have audited same in accor-
dance with IC 5-11-10-1.6.
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
pp��
J ALLOWED 20
AA M (on+r Torj (or - IN SUM OF $
59-99 W W MA �f
Z_IonsVi& 1:ff 4ln -7
$ 3 5-3 , 057. o0
ON ACCOUNT OF APPROPRIATION FOR
Cc s h cK
Board Members
PO#or DEPT.# INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s),
153,6 7 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
I�— I —2015
Sgn ture
ExecuUmb Director
Title
Cost distribution ledger classification if Carmel Redevelopment Commission
claim paid motor vehicle highway fund