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HomeMy WebLinkAboutLegacy TIF draw request 23 121015 FALCON NEST II , I. I. 0 December 11,2015 Diana L. Cordray Carmel Clerk Treasurer (317)571-2414 Via E-mail: DCordrayAcarmel.in.gov; csheekspcarmel.in.gov; john.alexander@regions.com; iake.taylorastarfinancial.com Re: Legacy TIF—Draw#23 Dear Diana: Attached please find the Legacy TIF draw for the current month. If everything is in order, please sign the Request foe Disbursement Form and forward this draw to the Trustee. Also attached is a budget sheet that will track all costs to date. Please let me know if you have any questions. Sincerely, _ f n Rajai Zu of Member of SALT, LLC gx 1 1356 BEVERLY RD SUITE 250 • MCLEAN, VA •22101 PHONE: (703) 893-7233 • FAX: (703) 893-5267 ( STATEMENT NO. 23 REQUESTING DISBURSEMENT OF FUNDS FROM PROJECT FUND PURSUANT TO SECTION 4.3 OF THE TRUST INDENTURE BETWEEN THE CITY OF CARMEL, INDIANA AND REGIONS BANK, AS TRUSTEE Pursuant to Section 4.3 of the Trust Indenture (the "Indenture") dated as of December 1, 2013, between the City of Carmel, Indiana (the "Issuer") and Regions Bank (the "Trustee"), the undersigned, as the Authorized Representative (as defined in the Indenture) of the Company, hereby requests and authorizes the Trustee, as depository of the Project Fund created by and as defined in the Indenture to pay to the Company or to the person(s) listed on the Disbursement Schedule attached hereto out of the moneys on deposit in the Project Fund, the aggregate sum of $ L 5r 03.01 to pay such person(s) or to reimburse the Company in full, as indicated in the Disbursement Schedule, for advances, payments and expenditures made by it in connection with the items listed in the Disbursement Schedule. In connection with the foregoing request and authorization, the undersigned hereby certifies that: (a) the costs of an aggregate amount set forth in this written request have been made or incurred and were necessary for the construction of the Project and were made or incurred in accordance with the construction contracts, plans and specifications,or purchase contracts therefor then in effect or that the amounts set forth in such written request are for allowable Costs of Construction of Project; (b) the amount paid or to be paid, as set forth in this written request, is reasonable and represents a part of the amount payable for the Costs of Construction of the Project all in accordance with the cost budget; and that such payment was not paid in advance of the time, if any, fixed for payment and was made in accordance with the terms of any contracts applicable thereto and in accordance with usual and customary practice under existing conditions; (c) no part of said costs was included in any written request previously filed with the Trustee under the provisions hereof; and (d) such costs are appropriate for the expenditure of proceeds of the Bonds under the Act. This statement and all exhibits hereto, including the Disbursement Schedule, shall be conclusive evidence of the facts and statements set forth herein and shall constitute full warrant, protection and authority to the Trustee for its actions taken pursuant hereto; and This statement constitutes the approval of the Company of each disbursement hereby requested and authorized. 1 IN WITNESS WHL EOF, the authorized representative of the Company has set his hand as of the iUu, day of ,e- , 20 tS" Pursuant to Section 4.3 of the Indenture the foregoing disbursement request is hereby FALCON NEST II LLC, an Indiana limited liability company By: SALT, LLC, Member 4gov. By: _ { Rajai 2,umot,7:ea .er of SALT,LLC approved: CITY •.` ARMED \ A. Diana L. Cordray, IAMC, Clerk-`'rasurer 2 Legacy TIF Draw • 1 Application No.: 23 _ : Application Date: 10-Dec-15 Prepared By: Kathy Tekulve Telephone No: (317) 863-2052 Amount : $ 45,203.01 Reference or Total Retainage ; Invoice • Work This Invoice Code Contractor/ Payee Number Completed Period Amount 3 Stoeppelwerth &Assocs, Inc. TT 201422 $ 4,220.00 $ - $ 4,220.00 Weihe Construction 4490 $ 1,465.00 $ - $ 1,465.00 $ 5,685.00 $ - $ 5,685.00 11 Hittle Landscaping 69107 $ 12,914.73 • $ (1,291.47) $ 11,623.26 •Bullseye Fence Design, LLC 93607 $ 6,900.00 $ - $ 6,900.00 $ 19,814.73 $ (1,291.47). $ 18,523.26 12 Traffic Sign, Inc. 2013907 $ 8,868.75 $ - $ 8,868.75 Luminaire Service, Inc. 63926 $ 8,207.30 $ - $ 8,207.30 • $ 17,076.05 $ - $ 17,076.05 15 Conco Curbs& Paving, LLC App 2 $ 850.00 $ (85.00)• S 765.00 $ 850.00 $ (85.00) $ 765.00 Management Fees 1106 $ 3,256.93 $ (103.24) $ 3,153.70 • $ 3,256.93 $ (103.24) $ 3,153.70 i Total $ 46,682.71 $ (1,479.71) $ 45,203.01 0 } xxA 1 oft I PLATINUM PROPERTIES MANAGEMENT COMPANY, LLC INVOICE 1106 December 10, 2015 Zumot Real Estate Management, Inc. rzumot@zumot.net Falcon Nest II, LLC 1356 Beverly Road Suite 300 McLean, VA 22101 Re: Development Service Fees- The Legacy TIF Draw } Summary of December 2015 Construction Costs: Stoeppelwerth &Assocs., Inc. $ 4,220.00 Weihe Construction, Inc. $ 1,465.00 Hittle Landscaping $ 11,623.26 Bullseye Fence Design, Inc. $ 6,900.00 Traffic Sign, Inc. $ 8,868.75 Luminaire Service, Inc. $ 8,207.30 Conco Curbs & Paving, LLC $ 765.00 Total Monthly Costs $ 42,049.31 Development Fee @ 7.5% $ 3,153.70 Please remit payment to: Platinum Properties Management Company, LLC 9757 Westpoint Drive,Ste 600 Indianapolis, INI 46256 yt 9757 Westpoint Drive,Suite 600, Indianapolis,IN 46256(317)818-2900 STOEPPEIWERTH i _�_ t• ofc: 317.849.5935 7965 East 106th Street �`� A fax: 317.849.5942 Fishers,Indiana 46038-2505 ALWAYS OH www.stoeppelwerth.com FALCON NEST II,LLC Invoice number 201422 CIO PLATINUM PROPERTIES,LLC Date 12/08/2015 9757 WESTPOINT DRIVE SUITE 600 Project 55115PLA-CC2 OVERLOOK AT INDIANAPOLIS,IN 46256 LEGACY,SEC 2-CHERRY CREEK BOULEVARD Professional Services for the Period: November 2015 Contract Percent Total Prior Current Description Amount Complete Billed Billed Billed Final Design Construction Document Preparation 11,950.00 100.00 11,950.00 11,950.00 0.00 Project Management/Permitting 1,500.00 100.00 1,500.00 1,500.00 0.00 Coordination with Williams Creek Consulting 1,000.00 100.00 1,000.00 1,000.00 0.00 Micro Pool Design&Construction Plans 1,950.00 100.00 1,950.00 1,950.00 0.00 Subtotal 16,400.00 100.00 16,400.00 16,400.00 0.00 Construction Services Construction Staking 9,000.00 100.00 9,000.00 9,000.00 0.00 Subtotal 9,000.00 100.00 9,000.00 9,000.00 0.00 , Completion Certifications Ditch in center of Boulevard 1,300.00 100.00 1,300.00 0.00 1,300.00 Storm Sewers 1,800.00 100.00 1,800.00 0.00 1,800.00 Sanitary Sewers(Including Lateral &Clean Out 170.00 100.00 170.00 0.00 170.00 Locations) Streets 1,900.00 0.00 0.00 0.00 0.00 Digital GIS Submittal 950.00 100.00 950.00 0.00 �5.Q,p0.� Subtotal 6,120.00 68.95 4,220.00 0.00 (4,220.00) Monumentation (,oh +Tr--III Street Centerline Monuments 2,040.00 0.00 0.00 0.00 0.00 Concrete Monuments 1,500.00 0.00 0.00 0.00 0.00 Subtotal 3,540.00 0.00 0.00 0.00 0.00 Additional Services 0.00 0.00 2,150.00 2,150.00 0.00 *3RD RE-CHECK OF CURB HUBS ALONG CC BLVD-$870 Total 35,060.00 90.62 31,770.00 27,550.00 4,220.00 i Invoice total ( 4.220.00 Aging Summary lir' Invoice Number Invoice Date Outstanding Current Over 30 Over 60 Over 90 Over 120 201422 12/08/2015 4,220.00 4,220.00 Total 4,220.00 4,220.00 0.00 0.00 0.00 0.00 FALCON NEST II,LLC Invoice number 201422 Project 55115PLA-CC2 OVERLOOK AT LEGACY,SEC 2-CHERRY CREEK BOULEVARD Date 12/08/2015 If any portion of this invoice is in dispute,it is the client's responsibility to notify Stoeppelwerth&Associates, Inc.in writing within thirty (30)calendar days from the date of the invoice. The client remains responsible for paying the undisputed portion of the invoice by the due date. Any invoices unpaid after 30 days shall incur a finance charge of one-and-one-half(1 %)percent of the invoiced amount per month,excepting any disputed portion of the invoiced amount. Payment thereafter shall be applied first to accrued interest and then fo the unpaid principal amount. jF {FF x - ' Invoice Number 4490 15215 Stony Creek Way,Noblesville,IN 46060 (317)776.2966 (317)776-3050(Fax) To: Platinum Properties,Inc. Date: October 12,2015 Attn: Tim Walter 9757 Westpoint Drive,Suite 600 • Indianapolis,IN 46256 Job: Legacy Meadows Sec.3 Description: Fix errosion channels and cut extra dirt off oftop of Cherry Creek ditch west ofround-a-bout xLabor&Equipment: Qty Unit Price Total Operator 10 hrs. $45.00 $405.00 Bobcat mini excavator 3 hrs. $75.00 $225.00 CAT skid steer 3 hrs. $60.00 $540.00 Single axle dump truck 3 hrs. $75.00 $225.00 CAT DSC dozer 1 hr. $70.00 $70.00 L11 -nF I $� s{ +C7e T� 1'I=1ZMS; REMIT TO: ';;;;,11::414V„, � +� i 15215 STONY CREEK WAY NET 30 NOBLESVILLE,IN 46060 , VeP, (13 ii�, oirc no. ca r ^ -" 69107 -<,1 . T TLE i `" LA NCSCAP1 N -G 17778 Sun Park Drive•Westfield,IN 46074 317.896.5697 • 317.896.2471 lax www.HittteLancisrape.cnm loh_,nation • The Overlook -Section 2 Platinum Properties 9757 Westpoint Drive, Suite 600 81 io: Indianapolis, IN 46256 jt 1r .Ii �p - t .:. • t R _ xwarci` a ' 1494 20514 Net 30 11/20/2015 Alun lit a , (1i t li X. t i t ll:� : 611' Pric Taxable 1 Contract Billing#1 12,914.73 12,914.73 N Landscape Installo 1 Retainage -1,291.47 -1,291.47 N r Lert hf - 1k SUBTOTAL 11,623.26 Taxably 0.00 x Tax 0.00 Buyer shall pay a:ate payment ciarge of I 1/2%per month(which is en annual percentage of 18%)on any poriicn _ of account nal psid Ivithln leas en invoice. Buyer shall pay all reasonable collection expenses ir!,i°!ding reasonable attorney's fees. .TO Ai ‘1:,i;;, 11 623.26 e APPLICATION FOR PAYMENT CAP702 Page: 1 of 2 To: PROJECT. Platinum Properties Management Co., OVERLOOK Application No. Application Date* Period To. Contract Date; 9757 Westpoint Drive Overlook at Legacy Sec 2-TIF Constr Suite 600 CommunityDr& Creek 1 NOV 20,2015 NOV 20,2015 OCT 26,2015 Indianapolis, IN 46256 Carmel, ICherry Project Nos: From Contractor, VIA ARCHITECT. Hittle Landscapin Inc. Distnbution List II Owner ❑ Construction Mgr 17778 Sun Park Dive ❑ Architect 11Field Westfield IN 46074 ❑ Contractor ❑ Other Phone:(317) 896-5697 CONTRACT FOR' Landscape Installation Contractor's Application for Payment CONTRACTOR'S CERTIFICATION: - - Application is made for payment as shown below,with attached Continuation Sheet. The Contractor's signature here certifies that, to the best of their knowledge, 3 1.Original Contract Amount: $ 12,914.73 this document accurately reflects the work completed in this Application for Payment.The Contractor also certifies that all payments have been made 't' 2. Net of Change Orders: $ 0.00 for work on previous Applicatio s r Payment and also that the Current ,;. ._ g 0 3. Net Amount of Contract: $ 12,914.73 Payment is Due. 6 '.M y E a 4.Total Completed&Stored to Date: $ 12,914.73 (Authorizing Signature)' ` - 5 ai y 5.Retainage Summary: Hittle Lands ping, Inc. n Date: NOV 20,2015 -. g m a. 10.00 %of Completed Work $ 1,291.47 State Authorized: Indiana O1 " . % County of: HAMILTON cm b. 0.00 of Stored Material $ 0.00 Vs c TTotal Retainage: $ 1,291.47 Subscribed ar sworn to before me this day of I (l c9lS .N i 6.Total Completed Less Retainage: $ 11,623.26 Notary Public: Debra S Kulaga , .S W�L - My Commission expires:April 30,2022 7. Less Previous Applications: $ 0.00 _,_._ - ARCHITECT'S CERTIFICATION: I 8. Current Payment Due,This Application: $ 11,623.26] The Architect's signature here certifies that, based on their own observations, I -- �— the Contract Documents and the information contained herein,this document accurately reflects the work completed in this Application for Payment. 9. Contract Balance(Including Retainage): $ 1,291.47 The Architect also certifies the Contractor is entitled to the amount certified CHANGE ORDER Activit "_..Add_4ions,..,.,.._._.....v-_Subtractions , for payment. Total previously approved: 0.00 ( 0.00 0.00 Total approved this Month: – AMOUNT CERTIFIED: 0.00 -———r Sub Totals: - 0.00 0.00 Date: NET of Change Orders: i 0.00 ! (Architects Signature) Software by:PEM Software Systems,Inc. 'I-800-803-1315 Copyright 2012© [-APPLICATION FOR PAYMENT - CONTINUATION SHEET ; CAP703 Page 2 of 2 Pages From: To: Project: Application No: 1, Hittle Landscaping, Inc. Platinum Properties Management Co., OVERLOOK Application Date: 11/20/2015 17778 Sun Park Drive 9757 Westpoint Drive Overlook at Legacy Sec 2-TIF Constr Period To: 1/20/2015 Westfield, IN 46074 Suite 600 Community Dr& Cherry Creek Phone:(317)896-5697 Indianapolis, IN 46256 Carmel, IN Contract Date: 10/26/2015 Architects Project#: A ' B C 0 I E F G H j I 1 L. 'Work Completed Materials Total Completed ,,. tem • Balance Retainage IDescription of Work Contract 1 Frorr±prc`Nous This Period Presently and Stored "�' To Finish (If Variable 1.(19 i Value i A t cab n Stored o(Nr E)In (TD+EaF) iG r,Cl:! (C-G) Rate) 1 I Cherry Creek Blvd Street Trees 12,914.73 0.00 12,914.73 0.00 12,914.73 100 i 0.00 1,291.47 } 1 } • t I •, I i . i i I ! I i r i 1 i F t I S SII 12.914:73{ 0.00 12,914.73 0.00 11;9.14:.73' 'I'00 0,001 1',291.47 Software by:PEM Software Systems,Inc. 1,1?OC-so34115,I;Qpy tgra.lot2 v CONTRACTOR AFFIDAVIT AND WAIVER OF LIEN FINAL X PARTIAL X PAYMENT TO FOLLOW Henry Janzen being duly sworn,state that he/she is the President of Hittle Landscaping, Inc. having contracted with Platinum Properties Management Co.,LLC. to furnish certain materials,labor and/or equipment as follows: all landscape services for a project known as The Overlook at The Legacy Section 2 ,located at Carmel, IN ,and owned by Falcon Nest II,LLC ,and further states: PARJ'JAL WAIVER: that the balance due from the owner is the sum of Eleven Thousand,Six Hundred Twenty Three and 26/100 Dollars($ 11,623.26 Receipt of which is hereby acknowledged;or X The payment of 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 receipt of such payment. FINAL WAIVER: that the final balance due from the owner is the stun of Dollars($ ) Receipt of which is hereby acknowledged;or , The payment of 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 receipt of such payment. THEREFORE,the undersigned waives and releases unto the Owner of said premises any and all lien or claims whatsoever on the above-described property and improvements thereon on account of labor or material or both,furnished by the undersigned thereto,and further certifies that no other party has any claire or right to a lien on account of any work • performed or material furnished to the undersigned for said project,and within the scope of this affidavit and waiver. t Hittle Landscaping •nc_ Compan me • . , . �� • Auth rized K presentative____ . 4.1c,d144. Title t E l f ! I l ' WITNESS: UC-, , c ' - ��c Signature Debra S Kulaga Printed Name of Witness - i � F BULLSEYE FENCE DESIGN, INC. Invoice PO BOX 941 NOBLESVILLE,IN 46062 Date Invoice# 10/6/2015 93607 Bill To: Platinum Properties 9757 Westpoint Dr. Suite 600 Indianapolis, IN 46254 Project PHONE: FAX: Date Completed Terms Overlook @ Legacy-Section 2 (317)774-0197 (317)774-1151 11/30/2015 Due on receipt Description Amount Install 46-8X8 Treated Pine Barrier Posts with Angle Top 6,900.00 LI TIF - I l c Please remit to above address. Thank you for your business. l Total $6,900.00 Per our Contract,"A finance charge equal to four percent(4%)of the total owed will be Payments/Credits 60.00 added to the account seven(7)days past due.Payment is due upon completion of project. Thereafter,a finance charge of four percent(4%)per month(21%annual percentage rate) will be added and computed on the average daily balance due." Invoice Balance Due tf ta1 AFFIDAVIT AND WAIVER OF LIEN X FINAL PARTIAL. X PAYMENT TO FOLLOW being duly sworn,state that he/she is the of Bullseye Fence Design,Inc having contracted with Platinum Properties Management Co.,LLC. to furnish certain materials and/or Iabor as follows: Invoice No. 93607 for a project known as Overlook cr Legacy Section 2 ,located at 146th Street and River Road ,and owned by Falcon Nest II,LLC ,and further states: PARTIAL WAIVER: that the balance due by the owner is the sum of Dollars(S ). Receipt of which is hereby acknowledged;or The payment of 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 receipt of such payment. FINAL WAIVER: that the final balance due by the owner is the sum of Six Thousand Nine Hundred And 00/100 Dollars($6,900.00). Receipt of which is hereby acknowledged;or X The payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which is given to and for said amount,effective upon receipt of such payment. THEREFORE,the undersigned waives and releases unto the Owner of said premises any and all lien or claims whatsoever on the above-described property and improvements thereon on account of labor or material or both,furnished by the undersigned thereto,and further certifies that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project,and within the scope of this affidavit and waiver. Company Name 1 S. lb •uthorized 'A s resentative Title 0 WITNESS: i,nature _ Printed Name of Witness t t . Traffic Sign, Inc./ The Streetscape Co. Traffic Sign,Inc.!The Streetscape Co. Invoice 317-845-9305 9402 Uptown Drive,Suite 1500 :7:1;'4,;:::.7:41* g AnifoliiiIP Indianapolis,IN 46256 US "a 11/13/2015 2013907 (317)845-9305 W+ ,� . ,r t3e . �. information@trafficsigninc.com Due on receipt 11/14/2015 Falcon Nest II,LLC 9757 Westpoint Drive Suite 600 Indianapolis,IN 46256 {r4�+.;:cfw,Vi..2ffiFZN-A rfi1 `.. r; 1 $11,608.20 Please detach top portion and return with your payment. itiSW Titir! )' 12e ,h, tOl--. -7.�y�,d FiT _ 9 The ix �y Sec Fleming 21 `q 4 PZ37 Oveflook [e�e S 2 1..:9:- 1'::-r: ::----. ;':: _.f... r '.,1'.:600.46:: - 'r- '.:1:':: r`' j ue �a r RGi tµ2 t .y 12E d'.. •Speed Limit signs 6 468.50 2,811.00 •No Parking signs Lei Li P2-I2[ 2 384.20 768.40 •One Way>>>signs -ruF - i Z c 2 t468r50 t c 937.00 •Round About Ahead sign "� w,-�, (V] - 1 t 5.57,- 50'� X57`50 •End of Road marker signs - —" 3 228.00 684.00 •Type III Barricade(Moveable) (� (449.602 j y-(1 p-� - •1 449.00 •Combo stop w/double sns �: r 2 889.55 i i 779:1Q 3 } •Double sns on single post + „i p�. .rt f 1 815.55 815.55 •Combo yield w/One Way&Do Not Enter signs "'4 1 753.55 1;753.5.51 •Combo stop w/double sns&One Way sign TICT.."I'�.; � _tZ, 1 963.55 963,55;; •Combo yield w/double sns,One Way,Do Not Enter 1 1,089.55 1;089.55 ? I .2 r Loi/ PZ- t'l-e 1 i 1 I l 7.71 4 " l; t ]ii 4.11.;0-811W .l 1."dt18 It n ` 4 L11 .. TIF - ftc < i &0$ .15 , a 1 AFFIDAVIT AND WAIVER OF LIEN FINAL PARTIAL PAYMENT TO FOLLOW being duly sworn,state that he/she is the of having contracted with LGsA., ate, -r.,a-�-�- 2QC-- to furnish certain materials and/or labor as follows: -.�7)t4,rr & cc .-for a projectpknown as e .L G G located at /� L. u / / ...._ ,and owned by ,and further states: PARTIAL WAIVER: that the balance due by the owner is the sum of Dollars($ ). Receipt of which is hereby acknowledged;or The payment of 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 receipt of such payment. / I FINAL WA R: that the final balance due by the owner is the urn of Tddii r. -_Q.{ 514A Dollars(S / COr. O Receipt of which is hereby acknowledged;or The payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which is given to and for said amount,effective upon receipt of such payment. THEREFORE,the undersigned waives and releases unto the Owner of said premises any and all lien or claims whatsoever on the above-described property and improvements thereon on account of labor or material or both,furnished by the undersigned thereto,and further certifies that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project,and within the scope of this affidavit and waiver. //7t "--<-7W-14:4e---r,LCCetpC &. y Name leil AuBiorized Representative Title WITNESS: Signature Printed Name of Witness Invoice Luminaire Service, Inc. 10652 Deandra Drive LUMMPI CIAI I IL HTrNC Zionsville, IN 46077 (317) 808-7010 (317) 733-2699 (fax) Date: 12/7/2015 Invoice No.: 63926 Bill to: Falcon Nest II, LLC Service at: Falcon Nest II, LLC do Platinum Properties 14471 Community Drive, Platinum Propertic Carmel, IN 46000 9727 Westpoint Drive, Suite 600 Indianapolis, IN 46256 Customer ID: 1204 Description: Work Order 25974 Projects Reference: Work Order 25974 Terms: Net 30 Days PO Number: Item Description Quantity Unit Price Amount Progress Billing 80.0% Complete TiF - 12 F OVERLOOK TIF Subtotal: $8,207.30 Initial invoice-80% Sales Tax: $0.00 PER QUOTE Payments: $0.00 Total Due: ($8.207.3 ') 1 �$`K 12` t 4 AFFIDAVIT AND WAIVER OF LIEN X FINAL PARTIAL PAYMENT TO FOLLOW Charles Ryerson being duly sworn, state that he/she is the President of Luminaire Service,Inc. having contracted with Platinum Properties Management Co., LLC to furnish certain materials and/or labor as follows: invoice No. 63926 for a project known as Falcon Nest II LLC,Overlook TIF, located at Carmel, Indiana,further states: PARTIAL WAIVER: that the balance due by the owner is the sum of Receipt of which is hereby acknowledged;or The payment of 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 receipt of such payment. FINAL WAIVER: that the final balance due by the owner is the sum of eight thousand two hundred seven and 30/100 dollars($8,207.30). Receipt of which is hereby acknowledged X The payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which is given to and for said amount,effective upon receipt of such payment. THEREFORE,the undersigned waives and releases unto the Owner of said premises any and all lien or claims whatsoever on the above-described property and improvements thereon on account of labor or material or both, furnished by the undersigned thereto, and further certifies that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Lumin ire Service, Inc. Co ny Name e` utharized R.presentative President Title 41, WITNESS: . Signature Deborah Ryan Printed Name of Witness APPLICATION FOR PAYMENT PROJECT NAME:The Overlook at The Legacy Section 2 OWNER: Falcon Nest II,LLC CONSTRUCTION MANAGER:Platinum Properties Mgmt Co.,LLC CONTRACTOR:Conco Curbs&Paving,LLC INVOICE NO: 2 CONTACT: CONTACT:Ed Fleming CONTACT:Ryan Wallis APPLICATION DATE: 11/9/2015 ADDRESS: 1356 Beverly Road,Suite 300 ADDRESS:9757 Westpoint Drive,Suite 600 ADDRESS:P.O.Box A RETAINAGE: 10% McLean,VA 22101 Indianapolis,IN 46256 Tipton,IN 46072 APPROVED BY:EEF Phone: Phone:1317)818-2900,590-8817(M) Phone:317-281-9775.0,765-675-2656( DATE: 12/8/2015 A B Cr Co D E I F G H=E+F+G 1=H/0 , J K L=J+K M=O-H+L N Project Cost work Description Unit Scheduled Work Completed Materials Total Completed % Previous Retainage Total BAL.TO Net Pay Code Code Price Value Previous This Stored And stored To Date Compl. Retainage This Period Retained PAY This Month The Overlook at The Legacy Section 2 On-site construction Lgy P2 8a Roll Curb&Gutter $6.30/LF $18,118.80 $18,118.80 $18,118.80 100% $1,811.88 $1,811.88 $1,811.88 Lgy P2 Sb Common Area Sidewalk $3.17/SF $3,074.90 $3,074.90 Lgy P2 8b ADA Ramps(5 Ft.) $400 Ea $2,800.00 $2,800.00 Lgy P2 15b Maintenance Bond $550.00 $550.00 $550.00 100% $55.00 $55.00 $55.00 $495.00 Cherry Creek Blvd Constructic Lgy TIF 8a Chairback Curb&Gutter $10.98/LF $28,163.70 $28,163.70 $28,163.70 100% $2,816.37 $2,816.37 $2,816.37 Lgy TIF 8b Common Area Sidewalk $3.17/SF $5,369.98 $5,369.98 Lgy TIF 8b ADA Ramps(5 Ft.) $400 Ea $3,200.00 $3,200.00 Lgy TIFGr 8b ADA Ramps(10 Ft.) $650 Ea $3,900.00 $3,900.00 — ---�-•-` "LgyuTIF,'�S15b 3 Maintenance Bond $850.00 $850.00 $850.00 $85.00 $85.00 $85.00 1 Cp'61'00- /) X21$ TOTAL $66,027.38 $46,282.50 $1,400.00 $47,682.50 72% $4,628.25_ $140.00 $4,768.25 $23,113.13 $1,260.00 a APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF TWO PAGE(S) 215034 TO OWNER: PROJECT: APPLICATION NO: 2 Distribution to: Platinum Properties Mgmt Co.,LLC Overlook @ Legacy Sec.2 9757 Westpoint Dr.,Suite 600 Indianapolis,IN 46256 PERIOD TO: OWNER FROM CONTRACTOR: VIA ARCHITECT: 11/9/2015 ARCHITECT Conco Curbs&Paving,LLC nCONTRACTOR P.O. Box A PROJECT# Tipton,IN 46072 SUBCONTRACT# CONTRACT DATE: _ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been Continuation Sheet,MA Document 0703.is attached- completed in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received ro• e Owner,and that current payment shown herein is now due. 1. ORIGINAL CONTRACT SUM $ 566,027.38 /, 2. Net change by Change Orders $ $0.00 CONTR•CT?.•: 3. CONTRACT SUM TO DATE(Line I ±2) $ 566,027.38 / / 4. TOTAL COMPLETED&STORED TO $ $47,682.50 > / DATE (Column 0 on 0703) By: Jib Date: (1/ / 1� 5. RETAINAGE:(Original Contract Only) Ry //al A� Project Manager KRIbTEEN WALTERS a. 10% of Completed Work $ 4,768.25 State of It Iona County ofs NOTARY PUBLIC STATE OF INDIANA (Column D+Eon G70.) Subsc ib And sN. urn to before me this day°FA/6 J albl�JDN MADISON COUNTY b. 0 %of Stored Material $ Notary blit �/E ( . "^ +MISSION EXPIRES 07 (Column F on G703) My Commis n spires: ,' ��-( /Q8l98 Total Retainage(Lines 5a+5b or Total in Column I of 0703) $ 4,768.25 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $_ 42,914.25 In accordance with the Contract Documents,based on on-site observations and the data (Line 4 Less Line 5 Total) comprising the application,the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge,information and belief the Work has progressed as indicated, PAYMENT(Line 6 from prior Certificate) 6`'14 5 41,,65.25 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE rb\ $ (• 1,260.00 7 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE tv $ 23;1.1771.3 (Line 3 less Line 6) AMOUNT CERTIFIED $ CHANGE ORDER SUMMARY ADDITIONS _ DEDUCTIONS_ (Attach explanation if amount certified differs from the amount applied. Initial all figures on this Total changes approved Application and onthe Continuation Sheet that are changed to conform with the amount certified.) in previous months by Owner ARCHITECT: Total approved this Month(#1) By: Date: TOTALSI This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. issuance.payment and acceptance of payment are without NET CHANGES by Change Order prejudice to any rights of the Owner or Contractor under this Contract. AIH DOCUMENT G702•APPLICATION AND CERTIFICATION FOR PAYMENT•1992 EDITION•AIA 01992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,N.W.,WASHINGTON.DC 20006-5292 s CONTINUATION SHEET A IA DOCUMENT G703 215034 AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT,containing APPLICATION NO: 2 Contractor's signed certification is attached. APPLICATION DATE: In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: Use Column I on Contracts where variable retainage for line items may apply. ARCHITECTS PROJECT NO: SUBCONTRACT NO. A B C D I E F G H I ITEM DESCRIPTION OF WORK CONTRACT WORK COMPLETED MATERIALS TOTA1. BALANCE RETAINAGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (0-C) TO FINISH APPLICATION STORED AND STORED (C-G) (D+E) (NOT TN TO DATE D OR E) (D+E+F) 10/ On-site Construction 1 Sa-Roll Curb $18,118.80 518.115.80 $18,118.80 100% $0.00 $1,811.88 8b-Common Area Sidewalk $3,074.90 50.00 0% S3.074,90 $0.00 8b-ADA 511 $2,800.00 $0.00 0% $2,800.00 $0.00 15b-Maintenance Bond $550.00 $550.00 5550.00 100% $0,00 555.00 Cherry Creek Blvd Construction 8a-Chairback Curb $28,163.70 $28,163.70 $28,163.70 100% S0.00 52,816.37 Sh-Common Arca Sidewalk $5.369.98 $0.00 0% 55.369,98 $0.00 Sb-ADA 5tt $3,200.00 $0.00 0% $3,200.00 $0.00 Sb-ADA 10ft $3,900.00 $0.00 0% $3.900.00 $0.00 I5b-Maintenance Bond $850.00 5850.00 $850.00 100% $0.00 $85.00 Change Orders GRAND TOTALS $66,02738 $46,282.50 $1,400.00 $0.00 $47,682.50 $18,344.88 $4,768.25 AIA DOCUMENT 0703 CONTINUATION SHEET FOR G702•1992 EDITION•AW-a lam G703•1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,N W WASHINGTON,D.C.260085292 AIA DOCUMENT 0703 CONTINUATION SHEET FOR G702•1992 EDITION ALA-01992 67034992 THE AMERICAN INSTITUTE CF ARCHITECYS.I?35 NEW YORK AVENUE.N W WASHINGTON,O.C.200e6.5232 1 1 AFFIDAVIT AND WAIVER OF LIEN Final X Partial X Payment to follow State of Indiana County of Tipton SS: Ryan Wallis being duly sworn states that she/he is Estimator/Project Manager of Conco Curbs&Paving,LLC having contracted with Platinum Properties Mgmt. to furnish certain material and labor for a project known as Overlook @ Legacy Sec.2 and does further state: Final Waiver: that the balance due from the owner is the sum of ( 1 ' dollars and /100 I i 1 receipt of which is hereby acknowledged; or l 1 the payment of which has been promised as the sole consideration for this Affidavit and t Final Waiver of Lien which shall become effective upon receipt of such payment. c Partial Waiver: that the balance due from the owner is the sum of ( $1,260.00 Twelve Hundred Sixty dollars and 00/100 receipt of which is hereby acknowledged; or 3 X the payment of 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 receipt of such payment. i Therefore,the undersigned waives and releases unto the Owner of said premises any and all lien or claim , whatsoever on the above-described property and improvements thereof • account of labor or materials or both furnished by the undersigned thereto,and further certifies that n• • er p.-1 asyy claim or right to a lien on account of any work performed or material furnished to the -1 ersig .-.fo (project,and within the scope of this Affidavit and Waiver. \/ / / . (signature) 11/9/2015 i (date) Witness my hand and notary seal,this I day of N O V ,201 W /4(4...-14–CoiLi") tit /0_4L ( I (signature) l� KRISTEEN WALTERS i NOTARY PUBLIC STATE OF INDIANA I My commission expires: / —V g MADISON COUNTY , 6t c�--��� Putt COM 1 SION EXPIRES 07/08118 My county of residence: MAD/60A) J!�� (Notary Public Print) ii z 1 z t i