Loading...
HomeMy WebLinkAbout259912 06/24/16 CITY OF CARMEL, INDIANA VENDOR: T358284 ONE CIVIC SQUARE F.A.WILHELM CONSTRUCTION CO INCCHECK AMOUNT: $...739,429.00' CARMEL, INDIANA 46032 3914 PROSPECT ST CHECK NUMBER: 259912 INDIANAPOLIS IN 46206 CHECK DATE: 06/24/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460805 33868 1 112,338.00 PARK EAST GARAGE 902 4460805 33868 2 627,091.00 PARK EAST GARAGE VOUCHER NO. WARRANT NO. Prescribed byState Board of Accounts . City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER F.A..WILHELM CONSTRUCTION CO INC IN SUM OF.$ 3914 PROSPECT ST CITY.OF,CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service INDIANAPOLIS; IN 46206 _ rendered,by whom,rates per day,number:pf hours,rate perhour,numberofunits;price perunit,etc.. . $739,429.00 0 Payee. Purchase Or ON ACCOUNT OF APPROPRIATION FOR der #. Redevelopment Commission Terms Date Due PO# ACCT# DATE: INVOICE#: DESCRIPTION: DEPT.# INVOICE# Fund# AMOUNT Board Members DEPT'# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 33868 1 44-608.05 $112,338.00. I:hereby certify that the attached irivoice(s),or 5/2/16 ] Park East garage construction=to be- $1.12338.00 902 902 902 . 902 reimbursed out of City Center II bond bill(s)is(are)true and correct and that the. 33868 2 44-608.05 $627,091.00 6/2/16. 2 Park East garage;construction-to be $6271091.00 902 902 materials or services itemized:thereon-for 902 902 reimbursed put of City Center li bond . which charge is made were ordered and received except Thursday,.June 16,2016. I hereby certify that,the attached invoice(s),or bill(s),is,(are),true and correct and I have au dited.same.in accordance With.IC 5-11-10=1.6 :20 Cost distribution ledger classification if claim paid motor vehicle highway fund.: . Clerk-TreaSUfer IPTC General Construction Contract—Exhibit "F" O��E�OPMEryT CO APubllcc/Private �> Partnership N z City of Carmel Indiana EXHIBIT F DESIGN-BUILDER APPLICATION FOR PAYMENT (to be used with the AIA G703 Schedule of Values) This request is for Interim Payment ❑ Final Payment STATE OF Indiana,COUNTY OF Marion,SS: Date: May 2,2016 Design-Builder: F.A.Wilhelm Construction Owner: CRC Company,Inc. 30 West Main Street, Suite 220 3914 Prospect Street Carmel, IN 46032 Indianapolis,IN 46203 Contract Date: March 16,2016 Project: CARMEL PARK EAST PUBLIC PARKING GARAGE City Center Carmel, IN 46032 Scope of Work: Design-Build Services and Construction Pay Request No.: 1 Contract No.: Period To: May 9,2016 Project No.: 10007 Invoice No.: 10007-1 Distribution: Owner ❑ Architect ❑ OR Ell 1. Original Contract: $ 13,922,314.00 2. Change by Change Orders: $ 0 3. Contract Sum to Date(Line 1 f 2): $ 13,922,314.00 4. Total Completed and Stored to Date: $ 124,820.00 (Past Certificates plus current Certificate) 5. Retainage at L% Withheld to Date: $ 12,482.00 6. Total Earned less Retainage(Line 4-5): $ 112,338.00 7. Less Previous Certificates for Payment: $ 0 8. Current Payment Due: $ 112,338.00 9. Balance to Finish plus Retainage(Line 3 -6): $ 13,809,976.00 1 IPTC General Construction Contract—Exhibit "F" DESIGN-BUILDER certifies that the Work covered by this Design-Builder Application for Payment has been completed in strict accordance with the Project specifications and provisions of the Contract and the Design- Build Documents, as changed by any written change order, and that payment under this Design-Builder Application for Payment does not cause the amount unearned under the Contract to be insufficient to cover the work not yet completed. DESIGN-BUILDER certifies that all amounts for the Work previously performed by Design-Builder and submitted under prior Applications for Payment have been paid by Owner and received by Design-Builder, less retention, and that the current payment shown herein is now due. By executing this Application for Payment, Design-Builder authorizes Owner to verify the payment status represented herein DESIGN-BUILDER also certifies that it has paid in full or otherwise satisfied all of its obligations to its consultants, contractors, subcontractors, materialmen, equipment suppliers, vendors, laborers, and employees for all labor performed,materials and equipment furnished,and services rendered to the Project whose work was incorporated on prior Applications for Payment up to and including the date hereof, and has paid or otherwise satisfied all other claims and indebtedness associated with the performance of the Contract,up to and including the date hereof. DESIGN-BUILDER further certifies that all lower-tier consultants, contractors, subcontractors and suppliers whose work in connection with the Project is incorporated or included in this Application for Payment have been paid or will be paid by Design-Builder upon or prior to payment to Design-Builder of the amount requested herein. By executing this Design-Builder Application for Payment, and in consideration and anticipation of payment to it of the approved amount contained herein, Design-Builder hereby acknowledges that Owner may rely upon its representations and certifications herein in making payment to Design-Builder, and Design-Builder further agrees to indemnify, defend and hold harmless Owner, its officers, agents, representatives, and employees, from and against any claim or lien of any kind whatsoever asserted through or under Design-Builder, including without limitation any claim or lien asserted by any person who has furnished labor,materials,equipment or services to Design-Builder, and from and against any and all damages, losses and expenses, including attorney fees, arising therefrom or incurred in connection therewith. IN WITNESS HEREOF, the undersigned individual, executing this Instrument, having first been duly sworn,upon oath,states that the representations set forth herein are true and correct and that(she)(he)has been duly authorized and empowered to execute and deliver this Instrument as of the day and year first above written. Date: S 2 F.A.WILHELM C TRUCTION COMPANY, INC.. lr�� Its Duly Authorized Representative °-A �k i I , A->s,+ 1 Printed Name and Title STATE OF �� f U^�^- ) SS: COUNTY OF /L4A/-cd— ) Subscribed and sworn to before me,a Notary Public, in and for said County and State this 20.4 qday of —,201 (,,. My Commission Expires: i �� Ilk Signature: My County of Residence Is: A46,_,-(0 Printed: �.A1111E0"% JUDITH D. B NDY t� •Noraer';:Notary Public, State of Indiana s'*. •*_ Marion County 2 '.SEA, : ? Commission#614882 My Commission Expires January 1312018 IPTC General Construction Contract—Exhibit "F" Received and approved for payment: ARC T: PROJECT OWNER'S REPRESENTATIVE: Pedcor Design Group,LLC By: By; 2ammoto lam 0A Printed Name and Title Printed Name and Title 0!-16-16 Date Date DS- t8- 2ot(0 3 APPLICATION AND CERTIFICATE FOR PAYMENT Invoice fl: 10007-1 To OwnerA.,'Carmel Redevelopment Commission Prolect: 10007-Park East Parking Garage Application No.: 1 tion to: 30 West Main Street L_.1 Owner Period To: 4/30/2016 Architect Carmel, IN 46032Contractor F—Q Owner Rep. From Contractor. F.A.Wilhelm Construction Co.,Inc. Via Architect 0 3914 Prospect St. Indianapolis,IN 46206 Project Nos: Contract For: 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 completed Continuation sheet is attached. 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 from the Owner,and that current payment shown herein is now due. 1.Original Contract Sum .......................... $13,922,314.00 CONTRACTOR: Wilhelm Construction Co.,Inc. 2.Net Change By Change Order .................... $0.00 .A. 3.Contract Sum To Date .......................... $13,922,314.00 y� / 4.Total Completed and Stored To Date............... $124,820.00 AIG Date: y 2- 5.Retainage: s' 10.001% of Completed Work $12,482.00 Stateof: Countyof: Subscribed and s om to before me this 2 s day of b. 0.00%of Stored Material $0.00 Notary Public: ,�its h My Commissio expires: 1 �.�tate��i, JUDITH�. BANDY / 3 /i� .4.....�. . t Notary Public,State of Indiana Total Retainage ............................. $12,482.00 / � :eoraR :*. �: s Marion County s .SEAL,: ommission 6.Total Earned Less Retaina a ....... ......... $112,338.00 ;. ..*�.� My Commission Expires g ARCHITECTS CERTIFICATE FOR PAYMENT 4,,1oir,N.. nuary 13,2018 In accordance with the Contract Documents,based on on-site oll 7_Less Previous Certificates For Payments............ $0.00 comprising the above application,the Architect certifies to the Owner that to the best of the Architect's knowledge,information,and belief,the Work has progressed as indicated, 8.Current Payment Due ........................... $112,338.00 the quality of the Work is in accordance with the Contract Documents,and the Contractor 9.Balance To Finish,Plus Retainage ................. $13,809,976.00 AMOUNT CERTIFIED $ 112,338.00 (Attach explanation if amount certified differs from the amount apptled.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) CHANGE ORDER SUMMARY Additions Deductions Total changes approved in previous months by Owner $0.00 $0.00 A' ITECT: _ Total Approved this Month $0.00 $0.00 By: Date: TOTALS $0.00 $0.00 This Certific to is not negoti 46tor T CERTIFIED is payable only to the Contractor named herein.Issud acceptance of payment are without Net Changes By Change Order $0.00 prejudice to any rights of the under this Contract. CONTINUATION SHEET Page 2of3 Application and Certification for Payment,containing Application No. : 1 Contractor's signed certification is attached. Application Date: 4/22/2016 In tabulations below,amounts are stated to the nearest dollar. To: 4/30/2016 Use Column I on Contracts where variable retainage for line items may apply. Architect's Project No.: Invoice#: 10007-1 Contract: 10007-Park East Parking Garage I Item Description of Work I Scheduled Materials Total % Balance Retainage No. � Value From Previous This Period Presently Completed (G/C) To Finish Application In Place Stared and Stored (C-G) (D+E) To Date of in D or E) D+E+F 1 Park East Parking Garage 100 General Conditions 700,559.00 0.00 30,000.00 0.00 30,000.00 4.28% 670,559.00 3,000.00 200 Structurepoint Design 257,629.00 0.00 78,020.00 0.00 78,020.00 3028% 179,609.00 7,802.00 300 Permits 97,550.00 0.00 0.00 0.00 0.00 0.00% 97,550.00 400 Earthwork 609,916.00 0.00 0.00 0.00 0.00 0.00% 609,916.00 500 Rammed Aggregate Piers 251,379.00 0.00 0.00 0.00 0.00 0.00% 251,379.00 600 Concrete 3,797,052.00 0.00 0.00 0.00 0.00 0.00% 3,797,052.00 700 Concrete Reinforcing 1,528,949.00 0.00 0.00 0.00 0.00 0.00% 1,528,949.00 800 Barrier Cable 79,713.00 0.00 0.00 0.00 0.00 0.00% 79,713.00 900 Tower Crane 388,764.00 0.00 0.00 0.00 0.00 0.00% 388,764.00 1000 Misc Metals 156,230.00 0.00 0.00 0.00 0.00 0.00% 156,230.00 1100 Handrails and Guardrails 161,440.00 0.00 0.00 0.00 0.00 0.00% 161,440.00 1200 Precast 2,121,983.00 0.00 0.00 0.00 0.00 0.00% 2,121,983.00 1300 Joint Sealants 58,744.00 0.00 0.00 0.00 0.00 0.00% 58,744.00 1400 Block/Brick/Cast Stone 838,397.00 0.00 0.00 0.00 0.00 0.00% 838,397.00 1500 Below Grade Waterproofing 1,072.00 0.00 0.00 0.00 0.00 0.00% 1,072.00 1600 Expansion Joint { 33,613.00 0.00 0.00 0.00 0.00 0.00% 33,613.00 1700 Deck Sealer and Traffic Membrane 112,307.00 0.00 0.00 0.00 0.00 0.00% 112,307.00 1800 joint-firestop at retail 53,599.00 0.00 0.00 0.00 0.00 0.00% 53,599.00 1900 Standing Seam Roofing-fascia-sofit 66,455.00 0.00 0.00 0.00 0.00 0.00% 66,455.00 2000 Aluminum Storefront 371,508.00 0.00 0.00 0.00 0.00 0.00% 371,508.00 2100 Hollow Metal Doors 4,824.00 0.00 0.00 0.00 0.00 0.00% 4,824.00 2200 Overhead Door 10,720.00 0.00 0.00 0.00 0.00 0.00% 10,720.00 2300 EIFS Cornice 237,443.00 0.00 0.00 0.00 0.00 0.00% 237,443.00 2400 Coping or Roofing at eifs cornice 48,239.00 0.00 0.00 0.00 0.00 0.00% 48,239.00 2500 Stair tower exterior partitions 75,039.00 0.00 0.00 0.00 0.00 0.00% 75,039.00 2600 Bike Racks/Litter Receptacle 10,693.00 0.00 0.00 0.00 0.00 0.00% 10,693.00 2700 Elevator 263,396.00 0.00 0.00 0.00 0.00 0.00% 263,396.00 2800 Pavement Markings 17,866.00 0.00 0.00 0.00 0.00 0.00% 17,866.00 2900 Painting 103,875.00 0.00 0.00 0.00 0.00 0.00°/a 103,875.00 3000 Signage 43,689.00 0.00 0.00 0.00 0.00 0.00% 43,689.00 3100 Awnings 1 24,120.00 0.00 0.00 0.00 0.001 0.00% 24,120.00 CONTINUATION SHEET Page 3of3 Application and Certification for Payment,containing Application No. : 1 Contractor's signed certification is attached. Application Date: 4/22/2016 In tabulations below,amounts are stated to the nearest dollar. To: 4130/2016 Use Column I on Contracts where variable retainage for line items may apply. Architect's Project No.: Invoice#: 10007-1 Contract. 10007-Park East Parking Garage Item Description of Work Scheduled Werk ram=W—T Materials Total % Balance Retainage No. Value From Previous This Period Presently Completed (G/C) To Finish Application In Place Stored and Stored (C-G) (D+E) To Date Not in D or E D+E+ _ 3200 Fire Extinguishers 12,462.00 0.00 0.00 0.00 - 0.00 0.00% 12,462.00 3300 Fire Protection 120,415.00 0.00 3,500.00 0.00 3,500.00 2.91% 116,915.00 350.00 3400 Plumbing/Mechanical 265,725.00 0.00 7,800.00 0.00 7,800.00 2.94% 257,925.00 780.00 3500 Electrical 466,125.00 0.00 5,500.00 0.00 5,500.00 1.18% 460,625.00 550.00 3700 Owners Contingency 530,824.00 0.00 0.00 0.00 0.00 0.00% 530,824.00 r i s Grand Totals 13,922,314.00 0.00, 124,820.00 0.00 124,820.00 0.90% 13,797,494.00 12,482.00 CRC Design-Build Agreement—Exhibit "G" ox�EIOPMEryT ' APublic/Private �w Part rship N v � 2 City of"Carmel. Indiana EXHIBIT G DESIGN-BUILDER AFFIDAVIT,PARTIAL WAIVER AND RELEASE OF LIEN (For use with periodic progress payment applications) STATE OF n,A«n(A, ,COUNTY OF Al I-V ,SS: Date: Design-Builder: F.A.Wilhelm Construction Owner: CRC Company,Inc. 30 West Main Street, Suite 220 3914 Prospect Street Carmel,IN 46032 Indianapolis,IN 46203 Contract Date: /1A6`rC't-" , 20 110 Project: CARMEL PARK EAST PUBLIC PARKING GARAGE City Center. Carmel, IN 46032 Scope of Work: Design-Build Services and Construction The undersigned, being duly sworn, deposes, certifies and says that: (i)he(she)is an officer of, and is duly authorized to make this Design-Builder Affidavit, Partial Waiver And Release of Lien on behalf of the above-named Design-Builder; (ii)Design-Builder has contracted with Owner to furnish certain labor and/or materials as follows: 0 e5 ir7_ G v,�dt S e r v�c-e_5 , for the above Project; (iii) the current balance due from Owner for labor performed and material furnished to said Project is the sum of Die r„,)r�-��+���i��-1'���� +�✓1��+��tHJ���� �� Dollars ($ 111-' 3�� ); (iv) Design-Builder has received all payments due to date under its Contract referred to above("Contract"), less applicable retention; (v) Design-Builder has paid in full or otherwise satisfied all of its obligations to its subcontractors, materialmen, equipment suppliers, vendors, laborers, and employees for all labor performed, materials and equipment furnished, and services rendered to the Project up to and including the date hereof, and has paid or otherwise satisfied all other claims and indebtedness associated with the performance of the Contract, up to and including the date hereof; (vi) Design-Builder has no other claims for changes, delays, acceleration, impacts or inefficiencies and the amount of payment above represents all current amounts owed to Design- Builder; and (vii) no other party has any claim, or right to a lien on account of any work performed, materials or equipment furnished,or services rendered for said Project under the Contract. FOR GOOD AND VALUABLE CONSIDERATION, including without limitation the payment received and to be received by it under the Contract, and in anticipation of the payment to it of the approved amount of the above request and effective upon and subject only to payment of such approved amount, Design- 1 CRC Design-Build Agreement—Exhibit "G" Builder, for itself and its consultants, contractors, subcontractors, materialmen, equipment suppliers, vendors, laborers,and employees HEREBY: (A) EXPRESSLY AND FOREVER WAIVES,RELEASES AND RELINQUISHES all rights to hold, assert, enforce or file any and all claims and liens which Design-Builder now has or may have against Owner, any other equitable or legal interest holder in the Project, the Project itself (including without limitation the real property on which such Project is located and the improvements thereon), Owner's Representative,Architect, and any third party contractor and its surety on the Project with whom Owner has a contract, for any and all labor performed, materials and equipment furnished, and services provided to or for the Project by or through Design-Builder as of the date of execution of this instrument;and (B) EXPRESSLY AND FOREVER AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS Owner, its officers, agents, representatives, and employees, any other equitable or legal interest holder in the Project, Owner's Representative, Architect, from and against any claim or lien of any kind whatsoever asserted through or under Design-Builder,-including without limitation any claim or lien asserted by any person who has furnished labor, materials, equipment or services to Design-Builder, and from and against any and all damages, losses and expenses, including attorney fees, arising therefrom or incurred in connection therewith. This Design-Builder Affidavit, Partial Waiver and Release of Lien has been executed and tendered by the undersigned on behalf of Design-Builder to induce payment by Owner of the above amount. Date: I �' I 1 F.A.WILHELM CONSTRUCTION COMPANY, INC.. Its Duly Authorized Representative al, Printed Name and Title STATE OF I C `cA/16-,,— SS: 16-,, SS: COUNTY OF /y1,aft d ) Subscribed and sworn to before me, a Notary Public, in and for said County and State this 2 day of A eA ,201 . / Ilk n My Commission Expires: 1 (3 I lk Signature: `�J My County of Residence Is: ✓4A/cd,/� Printed: 1 j A t JUDITH p. BANDY Notary Public, Stat®of Indiana g#.•;0TAR;'. Marion,County Commission M 614882 My Commission Expires I���rUN January 13, 2018 2 AV IPTC General Construction Contract—Exhibit "F" Co ' A Public l Private Partnership N u , z City of Carmel Indiana EXHIBIT F DESIGN-BUILDER APPLICATION FOR PAYMENT (to be used with theAlA 6703 Schedule of Values) This request is for 01,1n/terim Payment ❑ Final Payment STATE OF Indiana,COUNTY OF Marion,SS: Date: 6/2/16 Design-Builder: F.A.Wilhelm Construction Owner: CRC Company,Inc. 30 West Main Street, Suite 220 3914 Prospect Street Carmel, IN 46032 Indianapolis,IN 46203 Contract Date: March 16,2016 Project: CARMEL PARK EAST PUBLIC PARKING GARAGE City Center Carmel, IN 46032 Scope of Work: Design-Build Services and Construction Pay Request No.: 2 Contract No.: Period To: June 1,2016 Project No.: 10007 Invoice No.: 10007-2 Distribution: Owner ❑ Architect ❑ OR ❑ 1. Original Contract: $ 13,922,314.00 2. Change by Change Orders: $ 0 3. Contract Sum to Date(Line 1 ±2): $ 13,922,314.00 4. Total Completed and Stored to Date: $ 821,587.00 (Past Certificates plus current Certificate) 5. Retainage at 10% Withheld to Date: $ 82,158.00 6. Total Earned less Retainage(Line 4-5): $ 739,429.00 7. Less Previous Certificates for Payment: $ 112,338.00 8. Current Payment Due: $ 627,091.00 9. Balance to Finish plus Retainage(Line 3 -6): $ 13,182,885.00 1 .1 IPTC General Construction Contract—Exhibit "F" DESIGN-BUILDER certifies that the Work covered by this Design-Builder Application for Payment has been completed in strict accordance with the Project specifications and provisions of the Contract and the Design- Build Documents, as changed by any written change order, and that payment under this Design-Builder Application for Payment does not cause the amount unearned under the Contract to be insufficient to cover the work not yet completed. DESIGN-BUILDER certifies that all amounts for the Work previously performed by Design-Builder and submitted under prior Applications for Payment have been paid by Owner and received by Design-Builder, less retention, and that the current payment shown herein is now due. By executing this Application for Payment, Design-Builder authorizes Owner to verify the payment status represented herein DESIGN-BUILDER also certifies that it has paid in full or otherwise satisfied all of its obligations to its consultants, contractors, subcontractors, materialmen, equipment suppliers, vendors, laborers, and employees for all labor performed,materials and equipment furnished,and services rendered to the Project whose work was incorporated on prior Applications for Payment up to and including the date hereof, and has paid or otherwise satisfied all other claims and indebtedness associated with the performance of the Contract,up to and including the date hereof. DESIGN-BUILDER further certifies that all lower-tier consultants, contractors, subcontractors and suppliers whose work in connection with the Project is incorporated or included in this Application for Payment have been paid or will be paid by Design-Builder upon or prior to payment to Design-Builder of the amount requested herein. By executing this Design-Builder Application for Payment, and in consideration and anticipation of payment to it of the approved amount contained herein, Design-Builder hereby acknowledges that Owner may rely upon its representations and certifications herein in making payment to Design-Builder, and Design-Builder further agrees to indemnify, defend and hold harmless Owner, its officers, agents, representatives, and employees, from and against any claim or lien of any kind whatsoever asserted through or under Design-Builder, including without limitation any claim or lien asserted by any person who has furnished labor,materials,equipment or services to Design-Builder, and from and against any and all damages, losses and expenses, including attorney fees, arising therefrom or incurred in connection therewith. IN WITNESS HEREOF, the undersigned individual, executing this Instrument, having first been duly sworn,upon oath,states that the representations set forth herein are true and correct and that(she)(he)has been duly authorized and empowered to execute and deliver this Instrument as of the day and year first above written. Date: [ "L F.A2zi;Ke MPANY, INC—: By: Ir- 6 / Itsuly Authorized Represe tative D Printed Name and Title STATE OF SS: COUNTY OF _ Subscribed and sworn to before me,a Notary Public, in and for said County and State this try day of Jyn-C_ ,201 (v. r/ My Commission Expires: tS Signature: C'Q My County of Residence Is: /Ll�.i i u„ Printed: ` j'�` -,.� Eaa,,', JUDITH D. BANDY ,•'NOTARr• %NZ otary Public, State of Indiana 2 3*• * Marion County y :•5Fq�� Commission#614682 My Commission Expires January 13, 2018 IPTC General Construction Contract—Exhibit "F" Received and approved for payment: ARCHITECT: PROJECT OWNER'S REPRESENTATIVE: Pedcor Design Group,LLC By: 1_4-a v�zw-e C­t, A Printed Name nd Title Printed Name and Title 06 -03 - IFS Date Date 3 APPLICATION AND CERTIFICATE FOR PAYMENT Invoice#: 10007-2 To Owner: Carmel Redevelopment Commission Project: 10007-Park East Parking Garage Application No.: 2 tion to: 30 West Main Street Owner Period To: 5/31/2016 0 Architect Carmel, IN 46032 D Contractor 0 Owner Rep. From Contractor: F.A.Wilhelm Construction Co.,Inc. Via Architect: American Structurepoint, Inc. Q 3914 Prospect St. 7260 Shadeland Station Indianapolis, IN 46206 Indianapolis IN 46256 Project Nos: Contract For: 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 completed Continuation Sheet is attached. 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 from the Owner,and that current payment shown herein is now due. 1.Original Contract Sum .......... ....... ... ...... $13,922,314.00 2.Net Change By Change Order $0.00 CONTRAC R F.A.Wi 1 struction Co., Inc. 3.Contract Sum To Date .... . ....... . . .... .... .... $13,922,314.00 4.Total Completed and Stored To Date............. .. $821,587.00 BDate: 5.Retainage: (�tA,�(.Ry a a. 10.00% of Completed Work Sta e ofCounty of: rl «^ $82,158.00 Subscribed and sI to before me this 2 k� day of J v.�l Zv t4 b. 0.00°/o of Stored Material $0.00 Notary Public:/ C9-6 My Commissio expires:t 7F,rva,??AQ JUDITH D. BANDY Total Retainage $82,158.00 �5 '• Notary Public,State of Indiana � Marion Co$739,429.00 . My Commission Expires 6.Total Earned Less Retatnage .. .......... ... ..... . . ARCHITECT'S CERTIFICATE FOR PAYMENT �` Jprtualy 13,2018 In accordance with the Contract Documents,based on on-site obA4t 7.Less Previous Certificates For Payments........ .. . . $112,338.00 comprising the above application,the Architect certifies to the Owner that to the best of the Architect's knowledge,information,and belief,the Work has progressed as indicated, 8.Current Payment Due . ... .............. ...... . .. $627,091.00 the quality of the Work is in accordance with the Contract Documents,and the Contractor 9.Balance To Finish,Plus Retainage .............. . .. $13,182,885.00 AMOUNT CERTIFIED $ 627,091.00 (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Shee c ang form with the amount certified.) CHANGE ORDER SUMMARY Additions Deductions Total changes approved in previous months by Owner $0.00 $0.00 ARC Total Approved this Month $0,00 $0.00 By: Date: TOTALS $0.00 $0.00 This Certificate i not ne tiLTheOUNT ERTIFIED is payable only to the Contractor named herein.Issent,and ceptance of payment are without Net Changes By Change Order $0.00 prejudice to any rights of theo or under this Contract. CONTINUATION SHEET Page 2of3 Application and Certification for Payment,containing Application No. : 2 Contractor's signed certification is attached. Application Date: 6/1/2016 In tabulations below,amounts are stated to the nearest dollar. To: 5/31/2016 Use Column I on Contracts where variable retainage for line items may apply. Architect's Project No.: Invoice#: 10007-2 Contract: 10007-Park East Parking Garage Item Description of Work Scheduled Wnrk pleted Materials Total % Balance Retainage No. Value From Previous This Period Presently Completed (G/C) To Finish Application In Place Stored and Stored (C-G) (D+E) To Date Not in D or E D+E+F 1 Park East Parking Garage 100 General Conditions 700,559.00 30,000.00 12,034.00 0.00 42,034.00 6.00% 658,525.00 4,203.00 200 Structurepoint Design 257,629.00 78,020.00 115,202.00 0.00 193,222.00 75.00% 64,407.00 19,322.00 300 Permits 97,550.00 0.00 0.00 0.00 0.00 0.00% 97,550.00 400 Earthwork 609,916.00 0.00 487,933.00 0.00 . 487,933.00 80.00% 121,983.00 48,793.00 500 Rammed Aggregate Piers 251,379.00 0.00 2,514.00 0.00 2,514.00 1.00% 248,865.00 251.00 600 Concrete 3,797,052.00 0.00 37,971.00 0.00 37,971.00 1.00% 3,759,081.00 3,797.00 700 Concrete Reinforcing 1,528,949.00 0.00 15,289.00 0.00 15,289.00 1.00% 1,513,660.00 1,529.00 800 Barrier Cable 79,713.00 0.00 0.00 0.00 0.00 0.00% 79,713.00 900 Tower Crane 388,764.00 0.00 0.00 0.00 0.00 0.00% 388,764.00 1000 Misc Metals 156,230.00 0.00 0.00 0.00 0.00 0.00% 156,230.00 1100 Handrails and Guardrails 161,440.00 0.00 0.00 0.00 0.00 0.00% 161,440.00 1200 Precast 2,121,983.00 0.00 0.00 0.00 0.00 0.00% 2,121,983.00 1300 Joint Sealants 58,744.00 0.00 0.00 0.00 0.00 0.00% 58,744.00 1400 Block/Brick/Cast Stone 838,397.00 0.00 0.00 0.00 0.00 0.00% 838,397.00 1500 Below Grade Waterproofing 1,072.00 0.00 11.00 0.00 11.00 1.03% 1,061.00 1.00 1600 Expansion Joint 33,613.00 0.00 0.00 0.00 0.00 0.00% 33,613.00 1700 Deck Sealer and Traffic Membrane 112,307.00 0.00 0.00 0.00 0.00 0.00% 112,307.00 1800 joint-firestop at retail 53,599.00 0.00 0.00 0.00 0.00 0.00% 53,599.00 1900 Standing Seam Roofing-fascia-sofit 66,455.00 0.00 0.00 0.00 0.00 0.00% 66,455.00 2000 Aluminum Storefront 371,508.00 0.00 0.00 0.00 0.00 0.00% 371,508.00 2100 Hollow Metal Doors 4,824.00 0.00 0.00 0.00 0.00 0.00% 4,824.00 2200 Overhead Door 10,720.00 0.00 0.00 0.00 0.00 0.00% 10,720.00 2300 EIFS Cornice 237,443.00 0.00 0.00 0.00 0.00 0.00% 237,443.00 2400 Coping or Roofing at eifs cornice 48,239.00 0.00 0.00 0.00 0.00 0.00% 48,239.00 2500 Stair tower exterior partitions 75,039.00 0.00 0.00 0.00 0.00 0.00% 75,039.00 2600 Bike Racks/Litter Receptacle 10,693.00 0.00 0.00 0.00 0.00 0.00% 10,693.00 2700 Elevator 263,396.00 0.00 0.00 0.00 0.00 0.00% 263,396.00 2800 Pavement Markings 17,866.00 0.00 0.00 0.00 0.00 0.00% 17,866.00 2900 Painting 103,875.00 0.00 0.00 0.00 0.00 0.00% 103,875.00 3000 Signage 43,689.00 0.00 0.00 0.00 0.00 0.00% 43,689.00 3100 Awnings 24,120.00 0.00 0.00 0.00 0.00 0.00% 24,120.00 CON_,TINUATION SHEET Page 3of3 Application and Certification for Payment,containing Application No. : 2 Contractor's signed certification is attached. Application Date: 6/1/2016 In tabulations below,amounts are stated to the nearest dollar. To: 5/31/2016 Use Column I on Contracts where variable retainage for line items may apply. Architect's Project No.: Invoice#: 10007-2 Contract: 10007-Park East Parking Garage Item Description of Work Scheduled Wnrk pleted Materials Total % Balance Retainage No. Value From Previous This Period Presently Completed (G/C) To Finish Application In Place Stored and Stored (C-G) (D+E) To Date Not in D or E D+E+F 3200 Fire Extinguishers 12,462.00 0.00 0.00 0.00 0.00 0.00% 12,462.00 3300 Fire Protection 120,415.00 3,500.00 2,521.00 0.00 6,021.00 5,00% 114,394.00 602.00 3400 Plumbing/Mechanical 265,725.00 7,800.00 5,486.00 0.00 13,286.00 5.00% 252,439.00 1,329.00 3500 Electrical 466,125.00 5,500.00 17,806.00 0.00 23,306.00 5.00% 442,819.00 2,331.00 3700 Owner's Contingency 530,824.00 0.00 0.00 0.00 0.00 0.00% 530,824.00 Grand Totals 13,922,314.00 124,820.00 696,767.00 0.00 821,587.00 5.90% 13,100,727.00 82,158.00 CRC Design-Build Agreement—Exhibit "G" O��E�oPMfryr CO A Public/Private It 4� Partnership V . Z City of Carmel Indiana EXHIBIT G DESIGN-BUILDER AFFIDAVIT,PARTIAL WAIVER AND RELEASE OF LIEN (For use with periodic progress payment applications) STATE OF Indiana,COUNTY OF Marion,SS: Date: 6/2/16 Design-Builder: F.A.Wilhelm Construction Owner: CRC Company,Inc. 30 West Main Street, Suite 220 3914 Prospect Street Carmel,IN 46032 Indianapolis, IN 46203 Contract Date: March 16,2016 Project: CARMEL PARK EAST PUBLIC PARKING GARAGE City Center Carmel, IN 46032 Scope of Work: Design-Build Services and Construction The undersigned, being duly sworn, deposes, certifies and says that: (i)he(she) is an officer of, and is duly authorized to make this Design-Builder Affidavit, Partial Waiver And Release of Lien on behalf of the above-named Design-Builder; (ii)Design-Builder has contracted with Owner to furnish certain labor and/or materials as follows: Design Build Services,for the above Project; (iii)the current balance due from Owner for labor performed and material furnished to said Project is the sum of Six hundred twenty-seven thousand ninety-one Dollars ($627,091.00); (iv) Design-Builder has received all payments due to date under its Contract referred to above ("Contract"), less applicable retention; (v) Design-Builder has paid in full or otherwise satisfied all of its obligations to its subcontractors, materialmen, equipment suppliers, vendors, laborers, and employees for all labor performed, materials and equipment furnished, and services rendered to the Project up to and including the date hereof, and has paid or otherwise satisfied all other claims and indebtedness associated with the performance of the Contract, up to and including the date hereof; (vi) Design-Builder has no other claims for changes, delays, acceleration, impacts or inefficiencies and the amount of payment above represents all current amounts owed to Design-Builder; and(vii)no other party has any claim, or right to a lien on account of any work performed, materials or equipment furnished, or services rendered for said Project under the Contract. FOR GOOD AND VALUABLE CONSIDERATION, including without limitation the payment received and to be received by it under the Contract, and in anticipation of the payment to it of the approved amount of the above request and effective upon and subject only to payment of such approved amount, Design- ] CRC Design-Build Agreement—Exhibit "G" Builder, for itself and its consultants, contractors, subcontractors, materialmen, equipment suppliers, vendors, laborers,and employees HEREBY: (A) EXPRESSLY AND FOREVER WAIVES,RELEASES AND RELINQUISHES all rights to hold, assert, enforce or file any and all claims and liens which Design-Builder now has or may have against Owner, any other equitable or legal interest holder in the Project, the Project itself (including without limitation the real property on which such Project is located and the improvements thereon), Owner's Representative,Architect, and any third party contractor and its surety on the Project with whom Owner has a contract, for any and all labor performed, materials and equipment furnished, and services provided to or for the Project by or through Design-Builder as of the date of execution of this instrument; and (B) EXPRESSLY AND FOREVER AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS Owner, its officers, agents, representatives, and employees, any other equitable or legal interest holder in the Project, Owner's Representative, Architect, from and against any claim or lien of any kind whatsoever asserted through or under Design-Builder, including without limitation any claim or lien asserted by any person who has furnished labor, materials, equipment or services to Design-Builder, and from and against any and all damages, losses and expenses, including attorney fees, arising therefrom or incurred in connection therewith. This Design-Builder Affidavit, Partial Waiver and Release of Lien has been executed and tendered by the undersigned on behalf of Design-Builder to induce payment by Owner of the above amount. Date: C9 2- Ica F.A.WILHELM CONSTRUCTION COMPANY, INC.. By: G It my Authorized Representative Printed Name and Title STATE OF /L�ca�� ) SS: COUNTY OF /M OV W-1 ) _ Subscribed and sworn to before me, a Notary Public, in and for said County and State this 2n day of ,U.,\-c— ,201 (p. My Commission Expires: 1//-3 /1� Signature: My County of Residence Is: Printed: ,A%11Olt" JUDITH D. BANDY ``%N5`a'E 0A"A Notary Public,State of Indiana Marion County ? Commission#614882 SEA My Commission Expires +�i�NDtAN`�O� Januar 13, 2018 +Huta Y 2 Y CRCDesign-BuildAgreement—Exhibit `I" ��,409MFhrt :ty � ynhl CiofCar el Indiana Z EXHIBIT I SUBCONTRACTOR AFFIDAVIT,PARTIAL WAIVER AND RELEASE OF LIEN (For use with periodic progress payment applications) STATE OF Indiana,COUNTY OF Marion.SS: Date: June 3:2016 Subcontractor: American Structurepoint,Inc. Owner: CRC 7260 Shadeland Station 30 West Main Street, Suite 220 Indianapolis,IN 46256 Carmel,IN 46032 Design-Builder: F.A.Wilhelm Construction Project: CARMEL PARK EAST PUBLIC Company,Inc. PARKING GARAGE 3914 Prospect Street City Center Indianapolis,IN 46203 Carmel,IN 46032 Subcontract Date: December 1,2015 Subcontract Scope of Work: Design and Construction Administration The undersigned,being duly sworn,deposes,certifies and says that: (i)he(she)is an officer of,and is duly authorized to make this Subcontractor Affidavit,Partial Waiver And Release of Lien on behalf of the above- named Subcontractor, consultant or material supplier("Subcontractor"); (ii) Subcontractor has contracted with Design-Builder to furnish certain services, labor, equipment and/or materials as follows: Parking Strucuture .for the above Project;(iii)the current balance due from Design-Builder for services provided, labor performed, equipment and material furnished to said Project is the Sum Of One hundred twenty two thousand six hundred twenty six dollars and forty centsD011arS ($I22,626.40 ; , (iv) Design-Builder has received all payments due to date under its Subcontract referred to above ("Subcontract'), less applicable retention; (v) Subcontractor has paid in full or otherwise satisfied all of its obligations to its consultants, subcontractors, materWmen, equipment suppliers, vendors, laborers, and employees for all labor performed,materials and equipment furnished,and services rendered to the Project up to and including the date hereof, and has paid or otherwise satisfied all other claims and indebtedness associated with the performance of the Subcontract,up to and including the date hereof, (vi) Subcontractor has no other claims for changes, delays, acceleration, impacts or inefficiencies and the amount of payment above represents all current amounts owed to Subcontractor;and(vii)no other party has any claim,or right 1 CRC Design-Build.Igreement--Exhibit "I" to a lien on account of any work performed,materials or equipment furnished,or services rendered for said Project under the Subcontract. FOR GOOD AND VALUABLE CONSIDERATION,including without limitation the payment received and to be received by it under the Subcontract, and in anticipation of the payment to it of the approved amount of the above request and effective upon and subject only to payment of such approved amount, Subcontractor, for itself and its consultants, subcontractors, materialmen, equipment suppliers, vendors, laborers,and employees HEREBY: (A) EXPRESSLY AND FOREVER WAIVES,RELEASES AND RELINQUISHES all rights to hold, assert,enforce or file any and all claims and liens which Subcontractor now has or may have against Owner, any other equitable or legal interest holder in the Project,the Project itself(including without limitation the real property on which such Project is located and the improvements thereon), Owner's Representative, Architect,Design-Builder,Design-Builder's Surety and Design-Builder's contract proceeds to which it now or in the future may be entitled to receive from Owner or any third party,and any third party contractor and its surety on the Project with whom Owner has a contract, for any and all labor performed, materials and equipment furnished,and services provided to or for the Project by or through Subcontractor as of the date of execution of this instrument;and (B) EXPRESSLY AND FOREVER AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS Owner, its officers, agents, representatives, and employees, any other equitable or legal interest holder in the Project, Owner's Representative, Architect, Design-Builder and Design-Builder's Surety, from and against any claim or lien of any kind whatsoever asserted through or under Design- Builder, including without limitation any claim or lien asserted by any person who has furnished labor, materials, equipment or services to Subcontractor, and from and against any and all damages, losses and expenses,including attorney fees,arising therefrom or incurred in connection therewith. This Subcontractor Affidavit, Partial Waiver and Release of Lien has been executed and tendered by the undersigned on behalf of Subcontractor to induce payment by Design-Builder and Owner of the above amount. Date: June 3.2016 SUBCONTRACTOR: By: t'1Q/L(Z Its Duly Authorized Representative Scott S.Scoville,Chief Financial Officer Printed Name and Title STATE OF SS: COUNTY OF_Marron ) Subscribed and sworn to before me,a Notary Public,in and f sai County and State this_ 3rd day Of June ,201 . My Commission Expires: s-19 Signa My County of Residence Is: Marion Printed: Andra Y Lewi ,.` - KAR �Y K. ,19'3atE son" .. 2 �`"�� Of Alp°��,a