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181461 01/19/2010 /7: CITY OF CARMEL, INDIANA VENDOR: 363750 Page 1 of 1 i ONE CIVIC SQUARE ERMCO INC k.'• CARMEL, IND IANA 46032 Po BOX 1507 f' CHECK AMOUNT: $421,798.00 '9 INDIANAPOLIS IN 4 6206 CHECK NUMBER: 181461 zi.2 CHECK DATE: 1/19/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460807 124070.021 1,538.00 PERFORMING ARTS CENTE 902 4460807 124070.200 1,836.00 PERFORMING ARTS CENTE 902 4460807 19 418,424.00 PERFORMING ARTS CENTE 4A rmip t l ti 1 i 9 November 23, 2009 Mr. Les Olds Carmel. Redevelopment Commission One Civic Square Carmel, IN 46032 RE: Carmel City Center Performing Arts Center Shiel Sexton Project #2695 Errnco Invoice 124070.200 (EMERGENCY REMEDIAL WORK) Dear Mr. Olds: Based upon on -site observations and the data comprised in the billings, Shiel Sexton Company (Construction Manager) certifies to the owner that, to the best of their knowledge, information and belief, the Work has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the amount requested ($1,836.00). Sincere) 4. f ir I` David C. Burchard Senior Project Manager cc: Don Cleveland Mike Anderson Tony Eisenhut File I I I fi r te•... November 23, 2009 Mr. Les Olds Carmel .Redevelopment Commission One Civic Square Carmel, IN 46032 RE: Carmel City Center Performing Arts Center Shiel Sexton Project #2695 Ermco Invoice 124070.201 (EMERGENCY REMEDIAL WORK) Dear Mr. Olds: Based upon on -site observations and the data comprised in the billings, Shiel Sexton. Company (Construction Manager) certifies to the owner that, to the best of their knowledge, information and belief, the Work has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the amount requested ($1,538.00). Sincerely David .13 and Senior Project Manager cc: Don Cleveland Mike Anderson Tony Eisenhut File L/ ,4 =art, PO BOX 1507 INDIANAPOLIS, IN 46206 P.O. Box 1507 INVOICE DATE PAGE 1 1625 W. Thompson Road NUMBER 11/16/09 Indianapolis IN 46206 -1507 124070.201 BILL TO: SHIP TO: City of Carmel CARMEL PERFORMING ARTS CITY CENTER DRIVE &3RD AVE S.W. Carmel IN 46032 C/O BRYAN CHRIST CARMEL IN 46032 1 P 0 NUMBER 1 JOB 1 JOB DESCRIPTION ICUST #ICONTRACTI 1 124070ICARMEL PERFORMING ARTS 1 109041 QTY UOM DESCRIPTION UNIT PRICE AMOUNT 1,538.00 QUOTATION FOR T M WORK FOR THE ELECTRICAL HOOK UP OF DEHUMIDIFICATION EQUIPMENT PROVIDED BY CIRCLE B. Amount due 10 days from invoice date. A Service Charge of 1 1/2% per month (18% APR) will be added to invoices paid after due date. Main Phone (317)780-2923 Main Fax (317)780 -2853 TOTAL THIS INVOICE 1,538.00 PROPOSED CHANGE ORDER CCN 4320A -019 ERMCO ELECTRIC Date: 10/21/2009 Project Name: Carmel Performing Ar Project Number: 124070 Page Number: 1 Client Address: S h ieI- Sexton Contact: Dave Burchard Jim Place 902 North Capitol Indianapolis, Indiana 46204 Work Description We reserve the right to correct this quote for errors and omissions. We thank you for the opportunity of quoting the following work as herein described. Quotation for Allowance T M Work for the electrical hook up of dehumidification equipment provided be Circle B Allowance 4230A -019 Full Time CSR is excluded Quotation Amount 1,538.00 We sincerely hope this quotation will allow us to be of service to you and your company. If we may be of further assistance, please call our office. ERMCO Inc. By: Tony Gordon Title: Project Manager This quotation is based upon a normal work week, Monday thru Friday, 7:30AM to 4:OOPM (unless otherwise noted). This is a direct cost quotation. It does not include potential impact cost or other expenses attributive to delays and /or additional time in connection with this change, either individ- ually or in conjunction with other changes. The right to such compensation together with adjust- ments to contract time are fully reserved. Please note that NO action will be taken until written authorization is received by this office. ORIGINAL PROPOSED CHANGE ORDER Client Address: CCN 4320A -019 ERMCO ELECTRIC Shiel- Sexton Date: 10/21/2009 902 North Capitol Project Name: Carmel Performing Ar Indianapolis, Indiana 46204 Project Number: 124070 Page Number: 2 (Bill of material starting on the next page.) Itemized Breakdown Description Qty Net Price U Total Mat($) Labor U Total Hours 1 114" PVC 40 20 310.73 C 62.15 0.00 C 0.00 #6 THHN 100 1,284.22 M 128.42 0.00 M 0.00 30A/250V -FRN DUAL EL FUSE 3 6.18 E 18.54 0.00 E 0.00 30A/600V -FRS DUAL EL FUSE 3 13.71 E 41.13 0.00E 0.00 400 100A 250V FUSE REDUCER 3 20.25 E 60.75 0.00 E 0.00 T MLabor 16 0.00 0.00 1.00E 16.00 Xfiner rental 45Kva 1 125.00E 125.00 0.00E 0.00 Totals 435.99 16.00 Summary General Materials 435.99 Material Total 435.99 Foreman Rate (16.00 Hrs $60.11) 961.76 Subtotal 1,397.75 Markup 10.000 139.78 Subtotal 1,537.53 Final Adjustment 0.47 Final Amount $1,538.00 ORIGINAL PROJECT NO. 4� /f% i ��..i k d. %;za4 DAILY SIGNED TIME SHEET PROJECT NAM r3. DESCRIPTION OF WORK /4 C�0 y J �J -r-c-- WEEK ENDING '/y A MON. TUES. WED. THUR. FRI. SAT. SUN. TOTAL HOURS WORKED NAME C L ff/ /c j b/ 7 i ST 1 1/2 X 2X ST 1 1 /2 1 G.- ll'vI 2 ST 1/ 2 2 ST 11/2 3 2 ST 1 1 /2 4 2 ST 1 1 /2 5 2 ST 1 1 /2 6 2 ST 1 7 2 ST 1 8 2 ST 11/2 9 2 ST 1 1 /2 10 2 MATERIAL REQUISITIONS Q VG z ST 1 2X 3 Fiffe Q. TOTAL HOURS FMS ti co z- 1 17 E77 15 —W 77/77 J k. PROJECT NO. i;' lO ��i 0 47 acsatzmaressomany No. Y3 -t5. 1, PROJECT NAME atia tt. (W t DAILY SIGNED TIME SHEET DESCRIPTION OF WORK 77' 4- 44- .•c. 0 WEEK ENDING q- z o' 9 MON. TUES. WED. THUR. FRI. SAT. SUN. TOTAL HOURS WORKED NAME CL l /47 ST 11/2X 2X ST 1 1/2 1 sf 2 ST 1 2 2 sfa4t'e ST 1 V2 3 2 ST 1 1 4 2 ST 1 1 /2 5 2 ST 11 6 2 ST 1 7 2 ST 1 1 /z 8 2 ST 1 1 9 2 ST 1 10 2 MATERIAL REQUISITIONS z ST 1 1 /2X 2X Q TOTAL HOURS �a ae /1,7 ,00 EIMAIlefft 1 G PO BOX 1507 INDIANAPOLIS, IN 46206 P.O. Box 1507 INVOICE DATE PAGE 1 1625 W. Thompson Road NUMBER 11/16/09 Indianapolis IN 46206 -1507 124070.200 BILL TO: SHIP TO: City of Carmel CARMEL PERFORMING ARTS CITY CENTER DRIVE &3RD AVE S.W. Carmel IN 46032 0/0 BRYAN CHRIST CARMEL IN 46032 P 0 NUMBER 1 JOB I JOB DESCRIPTION ICUST #ICONTRACTI 1 1240701CARMEL PERFORMING ARTS 1 109041 QTY UOM DESCRIPTION UNIT PRICE AMOUNT 1,836.00 QUOTATION FOR T M WORK TO REMOVE AND REINSTALL PANELS IN WEST MECHANICAL ROOM FOR DRYWALL REMEDIATION Amount due 10 days from invoice date. A Service Charge of 1 1/2% per month (18% APR) will be added to invoices paid after due date. Main Phone (317)780 -2923 Main Fax (317)780 -2853 TOTAL THIS INVOICE 1,836.00 V�[IVIIYHL PROPOSED CHANGE ORDER CCN 4320A -018 ERMCO ELECTRIC Date: 10/21/2009 Project Name: Carmel Performing Ai Project Number: 124070 Page Number: 1 Client Address: Shiel Sexton Contact: Dave Burchard Jim Place 902 North Capitol Indianapolis, Indiana 46204 Work Description We reserve the right to correct this quote for errors and omissions. We thank you for the opportunity of quoting the following work as herein described. Quotation for Allowance T M work to remove and reinstall panels in west mechanical room for drywall remediation. allowance 4320A -018 Full Time CSR is excluded Quotation Amount 1,836.00 We sincerely hope this quotation will allow us to be of service to you and your company. If we may be of further assistance, please call our office. ERMCO Inc. By: Tony Gordon Title: Project Manager This quotation is based upon a normal work week, Monday thru Friday, 7:30AM to 4:OOPM (unless otherwise noted). This is a direct cost quotation. It does not include potential impact cost or other expenses attributive to delays and /or additional time in connection with this change, either individ- ually or in conjunction with other changes. The right to such compensation together with adjust- ments to contract time are fully reserved. Please note that NO action will be taken until written authorization is received by this office. ORIGINAL PROPOSED CHANGE ORDER Client Address: CCN 4320A -018 ERMCO ELECTRIC Shiel- Sexton Date: 10/21/2009 902 North Capitol Project Name: Carmel Performing Ar Indianapolis, Indiana 46204 Project Number: 124070 Page Number: 2 (Bill of material starting on the next page.) Itemized Breakdown Description Qty Net Price U Total Mat($) Labor U Total Hours T M Labor 32 0.00 E 0.00 1.00 E 32.00 Totals 0.00 32.00 Summary Journeyman Rate (32.00 Hrs $52.15) 1 Subtotal 1,668.80 Markup 10.000 166.88 Subtotal 1,835.68 Final Adjustment 0.32 Final Amount $1,836.00 ORIGINAL PROJECT NO. 2 1 '47; (L �L y�s ��jj W U A L) v' 4 `I: i 11` DAILY SIGNED TIME SHEET PROJECT NAME Lr A L t J DESCRIPTION OF WORM. j /tL e_d .1- 5 WEEK ENDING U MON. TUES. WED. THUR. FRI. SAT. SUN. TOTAL HOURS WORKED NAME CL 1 1 1 1 ST 1 2X ST 11/2 2 1 :J L/L/✓�'' f I ST 3 112 2 45 S Z -�i -�-J 2 ST 1 1/2 3 2 MM. 4 2 ST 1 5 2 ST 1 1 /2 6 2 ST 1 1 7 2 ST 1 12 8 2 ST 1/2 9 2 ST 1 1 /2 10 2 MATERIAL REQUISITIONS V ST 11/2X 2X TOTAL HOURS PROJECT NO I 6U I 2 11 E f 1 No. 4 /3vD/ --v/ o 4./.7t 44 DAILY SIGNED TIME SHEET PROJECT NAME DESCRIPTION OF WORK /4_,L..- IYL�r V�": ,`h"1 e' 4 rr�� 1 ICJ c /PP 0 WEEK ENDING 7 VA MON. TUES. WED. 1 THUR. 1 FRI. SAT. SUN. TOTAL HOURS WORKED NAME CL ST 11X 2X ST g 5— /3 1 4,- 1/2 /1,27 2 ST /3 11/2 2 -S ?r, ^AwfSt?" 2 ST 1 1 /2 3 2 ST 1 1/2 4 2 ST 1 i/z 5 2 ST 1 6 2 ST I i 1 7 2 ST 1 1 /2 8 2 W ST 1 Y2 9 1 I ST 11/ 10 2 MATERIAL REQUISITIONS ZA-e ST 1' X 2X TOTAL HOURS j(:) hi4 c'e T lit Prescribed by Sate Hoard of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER 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. Payee F� eo Purchase Order No. (507 Terms '7 /GLJ '`Z�iE _/5 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) (4 /G' l /2S id/ P /9' r r r�--C. Sir co l2 O f V076. zo a A f l Total 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 VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF G' /oa' %.S6 7 ON ACCOUNT OF APPROPRIATION FOR f� 2 /y��G5c�7 Board Members Po# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or /27o 26 4/yZc 65 3 i bill(s) is (are) true and correct and that the 7oz I20.26 ¥/{lo 2 °7 6.Ck materials or services itemized thereon for which charge is made were ordered and received except l 20 �Ca t. ignature f ater- Ons Cost distribution ledger classification if claim paid motor vehicle highway fund SL Subcontract Billing Report For Work Invoiced From 11/01/09 to 11130109 Subcontract 2695 4320:4320 EIeGtrl Job: 2695- Carmel- RPAC Construction Vendor: 2719 ERMCO fNC 777 3rd Ave. SW Carmel, IN 46032 Date 7tils Pe rip d Item Units I.iNI Unit Cost Amount Units!% Amount Units!% Amount 1 4320 EIEc1nti al LS 10539,00104 56.55% 6,961,363.24 3.92 413,424.00 Tout Conir .t Items 10,539,D00. i+ 5,961,36.3.24 413,424-00 kkk Change Orders k" 2 CCR #1038 Cubs Alternate LS 1 ,0D0.11t 0.00% 0.00 OtM0% 0.43 3 CCR tt013- 1.1achine•Less LS 11,500.40 73.9t% 8,500.00 0.00% 0.03 Elevators Alternate CCR 41025 RCP No. L5 58,852. 100.00% x,852.00 0.03 0.00 PAC -004 Load Bank CE titan 7 Atid lion of t=xttit it B to Prime, LS 0.D 0.01% 000 0.00 0.00 Contract Agreement 8 CCR 1047 SSC 1079ASI LS 4,218.00 0.00% 000 0.C.0% 0.00 PAC -037 Warming Kthen Chars 9 CCR1048 SSC 1121 RCP No. LS 18,859. 71.2t 13,500.00 26 37 5,0L0.00 00 RCP No. 006 Supp?e,nt 1 10 SSC t142RCP -011 Misc. LS 7550 10303% 7.554.00 0.00% 0.00 E'er Items 11 SSC 1C8OASI -038 &Suppl. LS 18,732.01 6- 4.06% 12 D.00% 0.00 g 1 Triplex Rev's Tata Change Order I 1Ems 1 1,197.1 32,406.00 5,000.00 Subcontract Totals: 10,527,003.00 5,928,957.24 418,424.00 Total Billings: 5,928,95T.24 418,424.00 Unpaid Retainage: 525,350.15 0.00 Discounts: 100 0,00 Nat Billings: 5,402,807.09 418,424,00 98 SSC CMa Projects Page 1 11/19/09 11:58:14 AP.1 Date Format MhlfDDl1'Y SLSubRi;tingRepo .rpt yi_,..,...,,, l 8 is l y Applicatf nand Cert� c a a f or P went Con u ctron: M a nager Adviser Edition: w EJECT parcel a l Pe rf or ming.; ArtSAPPLICATION N t7 :1 8...:.. plstr{bution to t• Td OWN :•srarme( RedevefgpmelitCbminls f �f.: :1 Civic Square:: C en t e r Interlor Roug h' PE .1 '1 (30 12 0 0 9 l r Ca I 4 6032 C Package P4 C CTIO N M/WAGER p FROM. .VIA:CONSTRUCTION MANA :.'.::CONT D AT A AI CHI'I ECT::0 PA. Bo .:1501t� .:4:.: :2::-.. Sh1ei ROJECT:NOS ;:2665 -4'320 j CONTIRACTOR:0 lndianapialis. 06 VIA'AR CS Arc e .'R F CANT ��carhal- :In s tallation o;U f e; li�iE t,f the aatlacti9i r' t �ONTRA S FU PAYMENT, nn,J Contra c t h i i t; t gc, intri'r tit i tift) It u ..b r l ,cf Ulz Wu li.'uvcttrd•.by thi A pP7tcna vn 'far P ayntzm lii'iat�en''com an.nccardt;nce we l l t th �1itpUuttl ul i m td f et its s hown below, ut cCtn w i c r i i t,tt i vlth �!t''' CnriraU ti u tudii A IA CJ itm t G Ena tu e i n enlr;.lh all :amnunt4' "peid .hy; lhetvn.. or fbt, r�tt`irh previr,ur: Ca I m t, ct n 7 t t c t?w ner.",uttt th It;;cun'en t. '.7'.. C ant t;lct T]neutlt c'titfiCa tcs.,tnr' Ptty antl r>± c zl v r•ct C n »1t: the OR IGINAL CONTRACT:SUM.:;:, 1 s.539iOOD00 mt:nt ti v d 2 Mat.chart a by:. Chan a g 9 5 1,,.99T.0 CO id`rRA CrO M 3 t T �9. 527.;i�113.00::: :.'s- .1)11ic '1 i/ 1 0/2 0ti9 4 TOTAL GO MP L E"I` E b ST DI 0 70 AATE n i C�7Q3j 5,928 957124 .5ttt 5. RE'1 .'''....2"... ..t.r t 1 i7 .uf m tert t�rk •.....'S uhs4rtttic d'srvornta °lx 5 0.15:.._.:..„ 1U Nove G,aiiii rit i Ja rnt,t:iT(13i .:i'.. 1 tne'thl9 �dyn1' i'•. b; r Nuts Publi c a U ":a .It` {Colulnn•1'stri'C7Q I+. ly. Cotiintls C MptrC S :r .rita1 i 1 o il Li nci a i Th iar.l x t 1 n 701) 5 3 :C PAYM a t! `ail t ln t1iC�Can [rACiv'I�t7LilirltntS';' b tn- nlitr,.t�sery aTI d.0 c tflllt soMprls( TOT ALEARNED LESS RETAINAGE 5,402,607'0$ appitcat t n; the• ConstrmJ tlo Mu nitg ,cr.iin d Atu hitc c t. c crtit y .iu Illc:'0 'nrr. i 1 t a 1Fthc l r {I:ilnc:�I [:csvLineS'lttial) owledbt;' inl` urfntitioif 'ttrtdheli ?hst ro r eFecl "i� Trttlir ticd:. the 911:411., 't i f .lh� Wo t c t n US CER' PIC 4�9B4' 1 1 83,09 ''ncbort� ant with 11u Coritx t Drctinien1s; and ih t5 citlitlt:d Lo 'paym e nL flf Lhe AMOtJN I LE55 PREIIIO L in e' ,1 n H n rior ':..tom B,.CUl7 Rf;NT PAYtENr oUE: 42 p.:, i:, :r :r 4.18, 4:00 TIFIEn ardiotlNT;CER:. ::(rVrcrrlr cxplruiaiinn:iFainolii2 crrlifiril rJi ers fmrq c uttii r ttdial all fgurrs o CETO_F NESI'1,.1 CL•UO ING'RETA #NAGS,',... l nn w ttarroww Slt�. t #rt;r .liiiri rii�Crlr1 rYrm•. :i in7 t .,..,:zt. Line'�:ltfis..t 5124'39 91'..': t at I. rte 6) C I7N S C C71olV:fY( I CI`Tr1T4C,Et73tD<at �UMMARy c7NS.. .17EI]UG 1.....N... .AR ,1 vrd. n. v r' ot,t1 ch.u, csa m t rG ataustnottths.h .t7i<nr.. i? Pp .l Y 09.00.: 46.D0)... :.f)iilG:' �Tu t t vets k Ni nt li. tppru Ut a It C eritfie ot.. �lc' btil,le ::I'li e: ;i �•'.:::':n:iinott heti±i IssS: nrc: .A �tncnC tJr' jEl� 9 f b l cc d i� c e t [t C rs :-:'.:::::1:'......:::::'-':' I U CA1 S ,4t)9.Qfl (66 ..P att Aa,xi,ltt cc aC p yn 7: pt u ts+ A .I 1 t k thc t r (1ntr iL K n t 'un dar thl� (:nntnai i`'LT:GIiANCES by Change Urticr v1 0 li' iF :r CAUT101 You should sign an ort lnal ALA: Cont O ocumer,1 on W hirti this tt�xt nppears In RED:'Ar1 orlpinal assures i_ c w t i l .no t` tat 'obscured .,:.,4:,.,.::;.-:.,..:_,-,,,,•;..,........, A Gocumont GTA21CMaTM'.= tti92' C opyrlght 1992 b y :1 I iu Arf,nrican In illutti tsl At Cf 111 i t Cls r J ll t s r1 I*1S reservod. WAANING;'ThJ AIA hoc imonl is prolu rt o ts typ U.5 Capyrlght L,sv and rntn orlon� t 4 Iinutnhorized roprorluction•ur dlatrI1 uilon or th16 ALA" Oecument,, or any p anlon of It; may ra In o v ivil and criminal porta we cItJob and wIll:bc prosecute to lha tt,axlrrvm =rc P r °r 1'utchgper' qr0 permitted to reproduca fort (1 QJ copy DI Ehi� dncumant wwhen completed. 7b ruperrt copyrig v OtAlll C;pntrect Rorum nt 0-ttt;,il Thu Arlinrlcen Inairyuto n! nrpnhc Y .4C i J .d w AFFIDAVIT AND WAIVER 01? LIEN STATE OF INDIANA Final_ Partial )SS: COUNTY OF MARION Rod Burton being duly sworn states that he is the Controller of ERMCO, INC. having contracted with City of Carmel (124070.016) to furnish certain materials and /or labor as follows: Electrical Installation for a project known as Parcel 7A, Regional Performing Arts Center Interior Rough Construction Package P4 located in Carmel, IN and does further state: PARTIAL WAIVER: That the balance due from the owner is the sum of FORTY FOUR THOUSAND SEX HUNDRED TWENTY SEVEN DOLLARS AND NOS /100(544,627.00) X the 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 from 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 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 Owner of said premises an y and all lien and claim 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. ERMCO, INC. by Rod Burton Controller Witness my hand and notarial seal, this 10 day of November,20O9. Notary Public My Commission Expires: 12/19/2015 Lou Anne Puckett Notary Public- Printed Signature County of Residence: Marion DATE (rt hDDIYYYY) I p p CERTIFICATE OF LIABILITY INSURANCE 10/14/2009 encoLcEll (317} R -35013 'FAX (317) 853 -3501 THIS CERTIFICATE I5 ISSUER AS A 1SIATTER OF INFORPAAT10t1 ONLY AND CONFERS NO Rl{3HT5 LFPON THE CERTIFICATE p y�3 F'Group.I2isk. ttanagement Inc. HOLDER- TNIS CERTIFICATE DOES NOT AMEND, EXTEUD OR 3pi Pennsylvania Parkway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Suits 100 TFttisnapalil3 iN 462 INSURERSAFFORCJHGCOVERAGE HAIL# IrsuaED •uf,'URERA Am9risure insurance Co. PR:MCO, Inc_ rf;l tl ATneTisure Mutual Ina Co. P.D. Box 1507 u��L�R c: II.;l'i�R 0: Indianapolis Di 46206 Ir,�LRER e COVERAGES THE FOLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REG LERWENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT MATH RESPECT TO W 1FCII PITS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLCIES AGF,RFGATF 1 IIIIT4 Sjybetin AY HAVE BEEN RF0f1CFD RY PAID cl AImS. WSNA LTR 1H5: 1 TYPE OF INSURANCE POLICY NULfBEH POLICY EFFECTIVE MDDIYI POLICY tram:W' EXPIRATION D•ATE(t'.AG'DAYY) DATE INIL4OIYYr LIMITS A G1r3iz"3lALLUAS;LRY CP22000197 12/31/2008 12/31/2009 fx,pi0. .5 1,040,000 COP/LL-�CI=I GENERAL Llll5I_FTY: PREWIS F ad cel s 300, 000 CL PASUAD_ I A {CCCIJR LIEDEXP An/ ire osssd .1. 1d, 000, ,PERSO \AI, &ADVeLR;aY S 1,000,0001 C 11SRA AGGRJ C-+ATS 2,000,000 GE1lLAccRE .zCT I A: Val DER PRAc�c- €oN =.ta�csif 2,000,004 PDUCY (X i toe t 1 B AUTON0 a:LE LIAE:Lin' CA2000196 12/31/2008 12 /31 /2009 CCNEIKEDSiNGLELJ.VIT f AlYAUTO (a »derxs f 1,004,040 ALL 04 4 0 F.UTCG 1'4G_Y NNR RY SG} it O AUTOS per P:nmi 3 H:--I MAUTOS BOXY XL LIV ©F,04—C.i `.EC AUTOS e� ile* g i PROPER DAMAGE (Per rec$erd.) GARAGE LIABILITY f f AUTO MILT -EA ACCIDENT f i ANYMJT0 4 OTT =R THAN EA ACC ALiTO CrfLY FAG L H 1 EXCESS.TACHRELLALIABILITY CT11312615 12/31/2008 12/31/2009 E2L E Quiti ,:m If 10,000,000 OCCUR f 1C.LA JSMAL'E A2G•REG..ATE 4 10,000,000 all Is DECLICTIELE 1 X R REIAL011 f 0 g S 5 WORKERSCOWENSADO AND 1TC10E1292S 12/31/2008 31/2009 s'r T 12 X Tt�-!' Y u'jj:r51 a +JR r• EMPLOYERS' LIABILITY A.W RoP ETDR'YARTNEfc'EXECLT E.L. EACH ACCIDENT 5 1,000,000 Cr' r'TCER.'tl_ri3ER EXCL 0Ems? Erper, iemi:been:kr 65ct£c- Er.Er:E11YE s 1,404,040, SPICisL PPO.1SItIj.S p I;‘r =Liti:ScAe A oTTJ Leased/Rented i POLICYiII/IT.s 1,000, Equip CPP2000197 12/31/2000 12/31/2009 ,SO,tioo Per Item 5150,000 Ice A Installation Floater cPP2000197 .12/31/2008 12/31/2009 $750,DC0 Per tun $750,000 Max A Installation Floater. cPp2000197 12/31/2008 12/31f2009 sip Lac $250,000Trana DESCRIPTION OF OFERATIONSLUCATIONS EHICLES EXCLUSIDNSADD O BY E inores 1lEHTr5PFC6lL PRDy15rO1JS Project: Carmel Regional Performing Arta Center SEE ATTACHED ROTES See S1anTcet Additional Insured Endorsement t10 days notice for non payment of premium. CERTIFICATE UPDATED FROM 10/14/09 CERTIFICATE HOLDER CANCELLA110N SHOULD ANY OF 1E ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE Shiel Sexton Company EXPIRATION DATE THEREOF, TIE ISSuu.NG INSURER wliL. ENDEAVOR TO 61AI. ATTN: Tom Flu tneil *670 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER ILWEEI TO THE LEFT. GUT 902 North Capitol Indianapolis, IN 46204 FAILURE TO DO SO SHALL ILNPDSE HO OBLIGATION DR LIAMIITY OF ANY KIND UPON ma INSURER, ITS AGENTS OR REPRESENTATIVES. AUITIDR4Ff} REPRESENTATIVE Daniel iI:.1:; /JJ•IF- ..,C ACORD 25(2001/08) a ACOFtD CORPORATION 1988 1 u Cr171C:n4ra. no. a...a I .rf., 1y k t f '17. 4 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the poficy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate horde( In lieu of such andorsement(s)- If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in feu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies fisted thereon. ACORD 25 (24011 0) Par2012 1145425 cm re) ces f r k COMMENTS/REMARKS 1 Carmel Regional Performing Arts Center I The Ccruerc al General Liability and Automobile police: have been endorsed to add Shiel Sexton Company, Co., Inc., City of Carmel Redevelopr.• nt Cora scion, CSO Architects, L 'A.cquis Consulting Engineers and Lynch, Harrison 5. Brui ie•re, Inc as Additional Insured. The Additional Insured endorsement includes Completed Operations for "your work". The Commercial General Liability Policy is endorsed to the General Aaareaa a applies separately to each protect. The Ccmmerca_ Genera_ L' ITorker "s Compensation and Automobile polices have been endorsed to include Waiver of Subrogation Endorsement, in favor of Shiel Sexton Ca- pa:,_., Inc. The Commercial General Liabiltiy Policy provided that the subcontractor' s policies are Prim. ry and Non-Contributory for the work on Shiel Sexton Company, Inc. projects. The Commercial General Liability, Autcm-bile Liability and Wor;{er s Compensation pccses have been endorsed to provide thirty (30) days notice of cancellation to Shiel Sexton Company, Inc. Installation Floater includes coverage for Material Stored at Gravbar Electric, 1.45 N. Harding St., Indianapolis, IN, 46202 valued at approximately $08,000.00. Shiel Saxton Company is added as additional insured and loss payee with respect to stored material shown above. QFRE_dARK COPYRIGHT 2000, AMS SERVICES INC. 4 t i ERMYICO, Inc" CPP2009197 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTOR'S BLANKET ADDITIONAL INSURED ENDORSEMENT lj Y l This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL UABILITY COVERAGE FORM MI of the terms, provisions, exclusions, and limitations of the coverage form apply except as specifically stated below. SECTION II WHO IS AN INSURED is amended to include as an insured any person or organization, carted an additional insured in this endorsement_ 1. Whom you are required to add as an additional insured on this policy under a written contract or agreement relating to your business; or 2. Who is named as an additional insured under this policy on a certificate of insurance. However, the written contract, agreement or certificate of insurance must require additional insured status for a time period during the term of this policy and be executed prior to the "bodily injury', "property damage 'personal injury', or "advertising injury" giving rise to a claim under this policy. If, however, "your work` was commenced under a letter of intent or work order, subject to a subsequent reduction to writing within 30 days from such commencement and with customers whose customary contracts require they be named as additional insureds, we will provide additional insured status as specked in this endorsement. 3. If the additional insured is: (a) An individual, their spouse is also an additional insured. (b) A partnership or joint venture, members, partners, and their spouses are also additional insureds. (c) A limited liability company, members and rnanagers are also additional insureds. (d) An organization other than a partnership, joint venture or lirnited liability company, executive officers and directors of the organization are also additional insureds. Stockholders are also additional insureds, but only with respect to their liability as stockholders. (e) A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. The insurance provided to the additional insured is limited as follows: 1. Thal person or organization is only an additional insured with respect to liability arising out of: (a) Premises you own, rent, lease, or occupy, or (b) Your ongoing operations performed for that additional insured, unless the written contract or agreement or the certificate of insurance requires your work" coverage (or wording to the same effect) in which case the coverage provided shall extend to your work" for that additional insured. Premises, as respects this provision, shall include common or public areas about such premises if so required in the written contract or agreement. Ongoing operations, as respects this provision, does not apply to °bodily injury' or "property damage occurring after. (1) AEI work including materials, parts or equipment furnished in connection with such work on the project (other then service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright Insurance Services Office, Inc., 2003 CG704803 Pagel oft A 'F (2) That portion of your work' out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 2, The limits of insurance applicable to the additional insured are the least cif these specified in the written contract or agreement, or in the certificate of insurance or in the Declarations for this policy, If you also carry an Umbrella policy, and the written contract or agreement or certificate of insurance requires that the additional insured status also apply to such Umbrella policy, the limits of insurance applicable to the additional insured under this policy shall be those specified in the Declarations of this policy, The limits of insurance applicable to the additional insured are inclusive of and not in addition to the limits of insurance shown in the Declarations. l 3. The additional insured status provided by this endorsement does not extend beyond the expiration or termination of a premises lease or rental agreement nor beyond the term of this policy. 4. Any person or organization who is an insured under the terns of this endorsement and who is also an insured under the terms of the GENERAL LIABILITY EXTENSION ENDORSEMENT, if attached to this poricy, shall have the benefit of the terms of this endorsement if the terms of this endorsement are broader. 5. If a written contract or agreement or a certificate of insurance as outlined above requires that additional insured status be provided by the use of CG 2010 11 85, then the terms of that endorsement, which are shown below, are incorporated into this endorsement as respects such additional insured, to the extent that such terms do not restrict coverage otherwise provided by this endorsement: ADDITIONAL INSURED OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization; Blanket Where Required by Written Contract, Agreement, or Certificate of Insurance that the terms of CG 2010 11 85 apply (1f no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section 0) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. Copyright, Insurance Services Office, Inc., 1984 CG 20 10 11 BS The insurance provided to the additional Insured does not apply to "bodily injury', "property damage "personal injury', or "advertrsing injury' arising out of an architect's, engineer's, or surveyor's rendering of or failure to render any professional services including but riot limited to: 1. The preparing, approving, or failing to prepare Or approve maps, drawings, opinions, reports, surveys, change orders, design specifications; and 2. Supervisory, inspection, or engineering services. Any coverage provided in this endorsement is excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent, or on any other basis unless the written contract, agreement, or certificate of insurance requires that this insurance be primary, in which case this insurance will be primary without contribution from such other insurance available to the additional insured. Intrudes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright Insurance Services Office, Inc. 2003 Page 2 of 2 CG 70 48 03 04 4 r FP 'QRY J UAL INSURANCE COMPANY 540 Maryville Suite 400 St. LOUIE, HO 6314 314 -453 -9660 CERTJFICATE OF INSURANCE '146 hereby certify that insurance coverage is now in force with our Cow, any as outlined below. This certificate does not emend, extend or alter the coverage afforded by the policy, TITLE DP INSDREi GRAYBAR'ELEC COMPANY, INC. Wi AL Policy }o: FM561 Effective: 01 Jan 2009 Account No: 1 -10830 Expires: 01 3an 2010 Description Location of Property Covered: Index No: 055525.22 €le nal Property Chicago Division: PP1 1300 West 16th. Street INDIANAPOLIS, IN 462022112 COVERS IN FORCE: (Subject to limits of liability, deductibles and all Conditions in the policy Insurance Provided: Peril: Limit of Liability: PROPERTY DAMAGE ALL RISK $755,000 ADDITIONAL INTERESTS: (Bee Page 2) Additional interests under the policy, consisting of, but, not limited to mortgagees, lenders lose payees, lose payees, and additional named insured,' are covered in accordance with Certificates of Insurance issued to such interests and on file with this Company, Loss, if any, shall be payable to such additional interests, as their interests may appear, and in accordance with loss payment provisions of the policy. Ma it ins ATTU: TOM HUTSELL Certificate: 00153 -001 SHIRE SEXTON COMPANY Eff.ectave t.e: 13- Aug -2409 902 NORTH .CAPITOL INDIANAPOLIS IN 46204 BY Authbr-ized dature /Date 1 of 2 e, i3- Aug -2009 VOUCHER NO. WARRANT NO. II 1 ALLOWED 20 Ci' IN SUM OF 1 PO Sox L Thdiolkpoli5, Z 44260— /50 411 W2-11,05 ON ACCOUNT OF APPROPRIATION FOR i le j 102_/ Board Members O# or D INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or 102 li L 1NeR 1 -1 L21, bO 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 .;f i .k. 2010 nr3.01 c a l n Dire r p e ations Title Cost distribution ledger classification if maim naid motor vehicle highway fund Imo s Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL y j ,az 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 r m co Purchase Order No. r B PO B ,X 1507 Terms I -7 Zn ti�n�,�l,s.�/ 1 4��,206 Date Due fi r Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) it /i %U 19 /119/ l P 7 �1� j-1 na T x 4. f t Y i rt t 4 1 3 •''':•;.:•--'1 t l' 7 Y d .4 r' f j t d ~S' r te. 4- ^c O e4 M. b S �.�i `S Y1 A 3" s ..f� s f t G a ft— yr 's r t h x4 2. y �rY Total r ,r I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor with IC 5- 11- 10 -1.6. i. 20 Clerk- Treasurer