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HomeMy WebLinkAbout182732 03/02/2010 CITY OF CARMEL, INDIANA VENDOR: 363792 Page 1 of 1 ONE CIVIC SQUARE W R DUNKIN SON, INC CARMEL, INDIANA 46032 PO BOX 2247 CHECK AMOUNT: $421,461.50 ANDERSON IN 46018 CHECK NUMBER: 182732 CHECK DATE: 312/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460807 010 38,250.00 PERFORMING ARTS CENTE 902 4460807 0838515093 5,465.00 PERFORMING ARTS CENTE 902 4460807 20 377,746.50 PERFORMING ARTS CENTE SL Subcontract Billing.Report For Work Invoiced From 12/01/09 to 12/31/09 Subcontract: '2695 =5010 5Q1,O.General Trades Job: 2695- Carmel RPAC Construction Vendor: 9279 W.R. DUNKIN SON. INC 777 3rd Ave. SW Carmel, IN 46032 Contracts F To Date �k Tlis�Period ."'342' �r6 x.w3q r 'j Item Units UM Unit Cost Amount Units/% Amount Units/% Amount 1 5010 General Trades LS 1,480,000.00 3265% 483,279.00 8.28% 122,500.00 Total Contract Items 1,480,000.00 483,279.00 122,500.00 Change Orders 2 5010 General Trades LS 81,040.0 98.72% 80,000.00 98,72% 80,000.00 Total Change Order Items 81,040.0 80,000.00 80,000.00 Subcontract Totals: 1,398,960.00 403,279.00 42,500.00 Total Billings: 403,279.00 42,500.00 Unpaid Retainage: 40,327.90 4,250.00 Discounts: 0.00 0.00 Net Billings: 362,951.10 38,250.00 98 SSC CMa Projects Page 1 12/16/09 09:50:21 AM Date Format MMIDD /YY SI-SubBillingReport .rpt Y% TM AI A Document G'7421CMa ®1992 Application and Certificate for payment Construction Manager Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A, #5010 Carmel APPLICATION NO: 010 Distribution to: Commission Performing Arts OWNER: X One Civic Square 777 3rd Ave S.W. Carmel, IN 46032 Carmel, IN 46032 PERIOD T0: December 31, 2009 CONSTRUCTION MANAGER: X ARCHITECT: X FROM W.R. Dunkin Son, Inc. VIA CONSTRUCTION Shiel Sexton Co., Inc. CONTRACT DATE: February 23, 2009 CONTRACTOR: X CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS: 25310H 2695/5010 2695 FIELD: Anderson, IN 46018 OTHER: CONTRACT FOR: Bid Pkg 45010 VIA ARCHITEC CSO Architects CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment, as shown below, in connection with the Contract. Contract Documents, that all amounts have n aid by the Contractor for Work for which previous Continuation Sheet, AIA Document G703, is attached. Certificates for Payment were issued yore is received from the Owner, and that current 1. ORIGINAL CONTRACT SUM 1,480,000.00 Payment shown herein i ow d 2. NET CHANGE BY CHANGE ORDERS 81,040.00 CO W U KI S INC C. 3. CONTRACT SUM TO DATE (Line 1 f 2) 1,398,960.00 Date: December 10, 2009 4. TOTAL COMPLETED STORED TO DATE (Column G on G703) 403,279.00 St of: Indiana 5. RETAINAGE: County of: Madiso a• 10 of Completed Work Subscribed and sworn to before (Column D E on G703) 40,327.90 me this 10th dayof December 2009 b• 0 of Stored Material Notary Public: Martha A. Carpente G2� (Column F on G703) 0.00 My Commission expires: January 08, 2017 Total Retainage (Lines 5a +5b or Total in Column I of G703) 40,327.90 CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE 362,951.10 In accordance with the Contract Documents, based on on -site observations and the data comprising (Line 4 Less Line 5 Total) this application, the Construction Manager and Architect certify to the Owner that to the best of their knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 324,701.10 accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8. CURRENT PAYMENT DUE I S 38,250.00 AMOUNT CERTIFIED 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied. Initial all figures on this ,Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) 1,036,008.90 CONSTRUCT tf{NA By: Date: CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARQWEE C Total changes approved in previous months by Owner 0,00$ 81,040.00 By: Date: 1� Total approved this Month 0.00$ 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Jntractor TOTALS 0.00S 81,040.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Chan e Order 81,040.00 AIA Document G702ICMaTM 1992. Copyright Q 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this Al a Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible underthe law. This document was produced by AIA software at 15:14:24 on 12/11/2009 under Order No.0754240912_1 which expires on 0511012010, and is not for resale. User Notes: (1920161635) Document 6703 -1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 010 containing Contractor's signed certification is attached. APPLICATION DATE: 12/10/2009 In tabulations below, amounts are in US dollars. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 12/31/2009 ARCHITECT'S PROJECT NO: 2531 OH A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS STORED AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD (NOT IN D OR E) DATE G C (C G) RATE) D E (D +E +F) 01010 Performance Bond 26,400.00 26,400.00 0.00 0.00 26,400.00 100.00% 0.00 2,640.00 Mobilize 01015 Demobilize 8,000.00 4,000.00 0.00 0.00 4,000.00 50.00% 4,000.00 400.00 Supervision 01020 Coordination 87,000.00 48,000.00 0.00 0.00 48,000.00 55.17% 39,000.00 4,800.00 General Conditions 01025 M 30,000.00 16,400.00 0.00 0.00 16,400.00 54.67%1 13,600.00 1,640.00 General Conditions 01026 L 34,000.00 18,000.00 0.00 0.00 18,000.00 52.94% 16,000.00 1,800.00 1400A Organ Facade Pipes 200,000.00 61,720.00 25,000.00 0.00 86,720.00 43.36% 113,280.00 8,672.00 Carpentry Labor 14008 Hours 32,000.00 32,000.00 0.00 0.00 32,000.00 100.00% 0.00 3,200.00 Provide Tie -Off 1400C Points at Balconies 25,000.00 0.00 0.00 0.00 0.00 0.00% 25,000.00 0.00 Vertical Partition System Backfoid 1400D Doors 15,000.00 0.00 0.00 0.00 0.00 0.00% 15,000.00 0.00 16'X16' Temporary 1400E Overhead Door 6,000.00 0.00 0.00 0.00 0.00 0.00% 6,000.00 0.00 Temporary OHD Enclosure and 1400F linsulation 10,000.00 1,644.00 0.00 0.00 1,644.00 16.44% 8,356.00 164.40 1000 SY of BX 1200 140OG Tensar Geogrid 17,000.00 4,117.00 0.00 0.00 4,117.00 24.22% 12,883.00 411.70 1400H 350 CY of #2 Stone 18,200.00 5,718.00 0.001 0.001 5,718.00 31.42% 12,482.00 571.80 AIA Document G703TM -1992. Copyright 1963, 1965, 1966, 1967,1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be I prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 15:00:31 on 12/11/2009 under Order No.075424 which expires on 05/10/2010, and is not for resale. User Notes: (1699771713) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS STORED AND STORED TO FINISH (IF VARIABLE APPLICATION (NOT IN D OR E) THIS PERIOD DATE (G C) (C G) RATE) (D E) (D +E +F) 1400J 200 CY of 953 Stone 10,000.00 0.00 0.00 0.00 0.00 0,00% 10,000.00 0.00 1400K General Allowance 75,000.00 0.00 50,000.00 0.00 50,000.00 66.67% 25,000.00 5,000.00 CAD As -Built 1400L Allowance 5,000.00 0.00 5,000.00 0.00 5,000.00 100.00% 0.00 500.00 General Clean Up 01560 M 4,000.00 300.00 0.00 0.00 300.00 7.50%1 3,700.00 30.00 01561 General Clean Up L 25,000.00 2,800.00 0.00 0.00 2,800.00 11.20%1 22,200.00 280.00 Final Cleaning (Items 01562 in BP 5010 10,000.00 0.00 0.00 0.00 0.00 0.00% 10,000.00 0.00 Dewatering for 9 02110 Months -M -Eq 18,500.00 18,500.00 0.00 0.00 18,500.00 100.00% 0.00 1,850.00 Dewatering for 9 02111 Months L -Eq 28,000.00 28,000.00 0.00 0.00 28,000.00 100.00%1 0.00 2,800.00 Piping from Tri -flex 02240 to Lift Station 21,000.00 21,000.00 0.00 0.00 21,000.00 100.00% 0.00 2,100.00 Interior Metal Fabrications 05504 Submittals 6,200.00 6,200.00 0.00 0.00 6,200.00 100.00% 0.00 620.00 Interior Metal Fabrications 05505 Materials 86,500.00 60,200.00 22,000.00 0.00 82,200.00 95.03% 4,300.00 8,220.00 Interior Metal 05506 Fabrications- Erection 24,000.00 2,700.00 16,000.00 0.00 18,700.00 77.92% 5,300.00 1,870.00 Miscellaneous Metals 05511 -M 5,640.00 0.00 3,500.00 0.00 3,500.00 62.06% 2,140.00 350.00 Miscellaneous Metals 05512 -L 2,500.00 0.00 1,000.00 0.00 1,000.00 40.00% 1,500.00 100.00 Interior Rough 06100 Carpentry M 28,000.00 0.00 0.00 0.00 0.00 0.00%1 28,000.00 0.00 Interior Rough 06101 lCarpentry L 36,500.00 0.00 0.00 0.00 0.00 0.00% 36,500.00 0.00 07810 1 Skylight Shade M 62,000.00 1,240.001 0.00 0.001 1,240.00 2.00% 60,760.00 124.00 AIA Document G703- -1992. Copyright 1963, 1965, 1966, 1967,1970, 1976, 1963 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This Ale Document is protected by U.S. Copyright Law and international Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be 2 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 15:00:31 on 12/11/2009 under Order No.07542 which expires on 0511012010, and is not for resale. User Notes: (1699771713) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (G C) FINISH (IF VARIABLE APPLICATION (NOT IN D OR E) DATE (C G) RATE) (D E) (D +E +F) Skylight Shade 0781.1 Installation 29,500.00 0.00 0.00 0.00 0.00 0.00 29,500.00 0.00 07910 Joint Sealants M 48,000.00 0.00 0.00 0.00 0.00 0.00 48,000.00 0,00 07911 Joint Sealants L 24,500.00 0.00 0.00 0.00 0.00 0.00 24,500.00 0.00 08810 Interior Glazing 42,000.00 840.00 0.00 0.00 840.00 2.00%1 41,160.00 84.00 09610 Access Flooring 19,500.00 0.00 0.00 0.00 0.00 0.0o%1 19,500.00 0.00 09710 iFRP Wall Panels M 1,000.00 0.00 0.00 0.00 0.00 0.00% 1,000.00 0.00 09711 FRP Wall Panels L 2,000.00 0.00 0.00 0.00 0.00 0.00% 2,000.00 0.00 Acoustic Fabric 09712 Wrapped Panels 42,500.00 0.00 0.00 0.00 0.00 0.00 42,500.00 0.00 10210 Toilet Compartments 44,000.00 0.00 0.00 0.00 0.00 0.00% 44,000.00 0.00 Backfold Door 10220 Tracks- M 5,000.00 0.00 0.00 0.00 0.00 0,00% 5,000.00 0.00 Backfold Door 10221 Tracks- L 4,560.00 0.00 0.00 0.00 0.00 0.00% 4,560.00 0.00 10222 Operable Partition 21,000.00 0.00 0.00 0.00 0.00 0.00%1 21,000.00 0.00 10223 Wire Mesh Partitions 9,500.00 0.00 0.00 0.00 0.00 0.00% 9,500.00 0.00 Toilet Accessories 10224 M 34,000.00 0.00 0.00 0.00 0.00 0,00% 34,000.00 0.00 Toilet Accessories 10225 L 28,000.00 1,000.00 0.00 0.00 1,000.00 3.57% 27,000.00 100.00 10510 Metal Lockers 16,500.00 0.00 0.00 0.00 0.00 0,010% 16,500.00 0.00 10520 Phenolic Lockers M 110,000.00 0.00 0.00 0.00 0.00 0.00% 110,000.00 0.00 1.0521 lPhenolic Lockers L 29,000.00 0.00 0.00 0.00 0.00 0.00% 29,000.00 0.00 10610 Corner Guards M 9,500.00 0.00 0.00 0.00 0.00 0.00% 9,500.00 0.00 10611 Corner Guards L 3,500.00 0.00 0.00 0.00 0.00 0,00 3,500.00 0.00 17001 Changr Order No. 01 81,040.00 0.00 80,000.00 0.00 80,000.00 98,72% 1,040.00 8,000,00 GRAND TOTAL $1,398,960.00 $360,779.00 $42,500.00 $0.00 $403,279.00 28.83 $995,681.00 $40,327.90 AIA Document G703- -1992. Copyright 1963, 1965, 1966, 1967,1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this Al a Document, or any portion of it, may result in severe civil and criminal penalties, and will be 3 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 15:00:31 on 12/1112009 under Order No.07542 which expires on 05/10/2010, and is not for resale. User Notes: (1699771713) AFFIDAVIT AND WAIVER OF LIEN ]FINAL X PARTIAL X PAYMENT TO FOLLOW State of Indiana, County of Madison SS Bradley Tyler being duly sworn states that he is the Project Manager of W. R. Dunkin Son, Inc. having contracted with City of Carmel Redevelopment Commission to furnish certain materials and /or labor as follows: Bid Package 5010- interior Finishes for a project known as Parcel 7A, Carmel Regional Performing Arts Center located at Carmel, Indiana and owned by City of Carmel and does hereby further state on behalf of the aforementioned Contractor. Application for Payment 08 has been received for work performed through 10/31/09. (PARTIAL WAIVER) that there is due from the contractor the sum of Thirty -four Thousand Four Hundred Twenty -two dollars and 30 /cents 34,422.30 Application for Payment has been received for work performed through (FINAL WAIVER) that the final balance due from the Owner is the sum of dollars and 00 /cents 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 thereon on account of LABOR or material or both, furnished by the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certifies that no other party has any claim or right to a lien on ac unt of any work performed or material furnished to the undersigned for said protect, and within scop h' a avit an aiver. W. R. Dunkin Son, Inc. Title: Project Manager WITNESS MY HAND AND NOTARIAL SEAL, this I& day of December 2009 'Z aaw (Notary Pu c) My Commission Expires: January 08, 2017 Printed Martha A. Carpenter Residing in Madison County Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be property 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 I So) Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) z S -D Olt er A RW (5 0 10) 2SD, OU 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 Anjers I& ej 2 .SQ. N 1 ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. a I hereby certify that the attached invoice(s), or 3YZ56,00 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 y -z6 20i DirJO evelopment Title Cost distribution ledger classification if claim paid motor vehicle highway fund d SL Subcontract Billing Report For Work Invoiced From 12/01/09 to 12/31/09 r Subcontract. '269540' 50 4050 General Trades Job: 2695- Carmel- RPAC Construction Vendor: 9279 W.R. DUNKIN SON, INC 777 3rd Ave. SW Carmel, IN 46032 Item Units UM Unit Cost Amount Units/% Amount Units/% Amount 1 4050 General Trades LS 12,235,000.00 67.63% 8,274,047,00 9.35% 1,143,503.00 Total Contract Items 12,235,000.00 8,274,047.00 1,143,503.00 Change Orders 2 CCR 1008 Oculus LS 228,000.00 100.00% 228,000.00 0.00% 0.00 Alternate 3 4050 General Trades LS 9,031.00 100.00% 9,031.00 0.00% 0.00 5 Opening 167B to Aluminum LS 2,196.0 1166% 300.00 0.00% 0.00 6 Shear Transfer/Lateral LS 98,741.00 100.00% 98,741.00 0,00% 0.00 Support Angle thru 06105/2009 9 AS] PAC -054 Auditorium LS 17,527.0 100.00% 17,52700 000% 0.00 Supply Air Distribution 10 ASI PAC -075 Door LS 11,292.0 100.00% 11,292.00 0.00% 0.00 Schedule Clarifications 12 4050 General Trades LS 44,936.0 100.00% 44,936.00 0.00% 0.00 13 Shear Transfer/Lateral LS 14,683.00 100.00% 14,68100 0.00% 0.00 Support 14 4050 General Trades LS 760,330.00 98.72% 750,57100 98.72% 750,573.00 Total Change Order Items -333,924.01 326,063.00 750,573.00 Subcontract Totals: 11,901,076.00 7,947,984.00 392,930.00 Total Billings: 7,947,984.00 392,930.00 Unpaid Retainage: 595,053.80 38,016.50 Discounts: 0.00 0.00 Net Billings: 7,352,930.20 430,946.50 98 SSC CMa Projects Pagel 12/17/09 02.43:27 PM Date Format MM /DD /YY SLSubBillingReport .rpt AN Document G702 /C ar" ®1992 Application and Certificate for Payment Construction Manager Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A, #4050 Carmel APPLICATION NO: 020 Distribution to: Commission Performing Arts OWNER: X One Civic Square 777 3rd Ave. S.W. PERIOD TO: December 31, 2009 CONSTRUCTION MANAGER: X Carmel, IN 46032 Carmel, IN 46032 ARCHITECT: X FROM W.R. Dunkin Son, Inc. VIA CONSTRUCTION Shiel Sexton Co., Inc. CONTRACT DATE: May 08, 2008 CONTRACTOR: X CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS 25310 26954050 2695 FIELD: Anderson, IN 46018 CONTRACT FOR: BP- #4050 General Trades VIA ARCHITEC CSO Architects OTHER: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Applicatiot r Payment has been completed in accordance with the Application is made for payment, as shown below, in connection with the Contract. Contract Documents, that all amounts ha y e Contractor for Work for which previous Continuation Sheet, AIA Document G703, is attached. Certificates for Pa en were issued payments eceived from the Owner, and that current 1. ORIGINAL CONTRACT SUM 12,235,000.00 payment shown e' now d 2. NET CHANGE BY CHANGE ORDERS 333,924.00 D K S INC. 3. CONTRACT SUM TO DATE (Line I f 2) 11,901,076.00 y: Date: December 10, 2009 4. TOTAL COMPLETED STORED TO DATE (Column G on G703) 7,947,984.00 St e of: Indiana 5, RETAINAGE: County of: Madis a. 5 of Completed Work Subscribed and sworn to before (Column D E on G703) 595,053.80 me this 1 0th day of December_, 20G� b. 0 of Stored Material Notary Public: Martha A. Carpenter (Column F on G703) 0.00 My Commission expires: January 0, Total Retainage (Lines 5a 5b or "total in Column I of G703) 595,053.80 CERTIFICATE FOR PAYMENT 6, TOTAL EARNED LESS RETAINAGE 7,352,930.20 In accordance with the Contract Documents, based on on -site observations and the data comprising (Line 4 Less Line 5 Total) this application, the Construction Manager and Architect certify to the Owner that to the best of their 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 6,921,983.70 knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8. CURRENT PAYMENT DUE I 430,946.50 AMOUNT CERTIFIED 4(31 vv fe 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanation if amount certired differs from the amount applied. Initial al figures on this Application and on the Continuation Sheet that are changed to conforrn with the amount certified.) (Line 3 less Line 6) 4,548 CONSTRUC ER: By: Date: 2 3 ©,L 1 9 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS AR ITEC ii Total changes approved in previous months by Owner 426,406.00 0.00 By: Date: b L Total approved this Month 0.00$ 760,330.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS 426,406.00 760,330.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order I 333,924.00 AIA Document G7021CMaTM —1992. Copyright 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 14:55:53 on 12111/2009 under Order No.0754240912_1 which expires on 05/10/2010, and is not for resale. User Notes: (1667463476) y/ AIA cu ent G703r ®1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 020 containing Contractor's signed certification is attached. APPLICATION DATE: 12/10/2009 In tabulations below, amounts are in US dollars. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 12/31/2009 ARCHITECT'S PROJECT NO: 25310 A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY AND STORED TO FINISH (IF VARIABLE APPLICATION NO. WORK VALUE PREVIOUS THIS PERIOD STORED DATE (G C) (C G) RATE) (NOT IN D OR E) D E) (D +E +F PERFORMANCE 01010 BOND 106,000.00 106,000.00 0.00 0.00 106,000.00 100.00% 0.00 10,600.00 MOBILIZE /DEMOB 01015 ILIZE 29,000.00 15,000.00 0.00 0.00 15,000.00 51.72% 14,000.00 1,500.00 SUPERVISION /CO 01020 ORDINATION 361,000.00 308,800.00 10,000.00 0.00 318,800.00 88.31 42,200.00 28,480.00 GENERAL 01025 CONDITIONS -M 380,000.00 302,000.00 1.4,000.00 0,00 316,000.00 83.16% 64,000.00 27,000.00 GENERAL 01026 CONDITIONS -L 98,000.00 80,000.00 4,000.00 0.00 84,000.00 85.71 1.4,000.00 7,000.00 ALLOWANCE STONE 140A0 WALKWAY 8,500.00 0.00 0.00 0.00 0.00 0.00% 8,500.00 0.00 ALLOWANCE- TEMPORARY 140BO HANDRAIL 38,000.00 27,769.00 0.00 0.00 27,769.00 73.08% 10,231.00 2,776.90 ALLOWANCE TEMPORARY DOORS /FRAMES /H 14000 IARDWARE 10,000.00 0,00 0.00 0.00 0.00 0.00 10,000.00 0.00 140DO ALLOWANCE -ICE 13,500.00 2,289.00 0.00 0.00 2,2.89.00 16,96% 11,21 1.00 207.10 ALLOWANCE 140E0 SECURITY 31,000.00 0.00 0.00 0.00 0.00 0.00% 31,000.00 0.00 ALLOWANCE 140F0 DUMPSTERS 191,700.001 50,868,001 5,940,001 0,001 56,808.00 29.63% 134,892.00 3,987.90 140(30 ALL 34,000.001 22,170.001 10,044.001 0.001 32,214.00 94.75% 1,786.00 2,200.90 AIA Document G703- -1992. Copyright O 1963, 1965, 1966, 1967,1970, 1978, 1963 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be 1 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 14.53:10 on 12/1112009 under Order No. 0754240912_1 which expires on 05/1012010, and is not for resale. User Notes: (1650865743) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY PREVIOUS AND STORED TO FINISH (IF VARIABLE NO. WORK VALUE THIS PERIOD STORED DATE (G. C) (C G) RATE) APPLICATION (NOT IN D OR E) (D E) (D +E +F) TRAILER CONNECTOR ALLOWANCE TRAILER 140H0 CLEANING 19,169.00 12,183.00 761.00 0.00 12,944.00 67.53% 6,225.00 1,066.10 ALLOWANCE -SITE 14010 SIGNAGE /SAFETY 22,000.00 10,839.00 0.00 0.00 10,839.00 49.27% 11,161.00 1,055.90 ALLOWANCE 140J0 GENERAL LABOR 320,000.00 207,705.00 8,377.00 0.00 216,082.00 67.53% 103,918.00 17,948.40 ALLOWANCE TEMPORARY FENCE 140KO MODIFICATIONS 5,000.00 4,008.00 0.00 0.00 4,008.00 80.16%1 992.00 400.80 ALLOWANCE 92 140LO OR #53 STONE 37,900.00 18,856.00 0.00 0.00 18,856.00 49.75% 19,044.00 1,885.60 ALLOWANCE WAREHOUSE 140M LEASE /LAYDOWN 0 /PARKING 500,000.00 9,427.00 490,573.00 0.00 500,000.00 100.00% 0.00 942.70 ALLOWANCE PARKING LOT INSTA LL/M A INTAT 140N1 N 100,000.00 55,324.00 25,000.00 0.00 80,324.00 80.32% 19,676.00 5,532.40 ALLOWANCE MAINT. -OFF SITE STAGING /PARKIN 140N2 G 35,000.00 6,987.00 283.00 0.00 7,270.00 20.77% 27,730.00 685.50 ALLOWANCE PARKING LOT REMOVE /REFURBI 14000 SH 100,000.00 2,745.00 0.00 0.00 2,745.00 2.75% 97,255.00 274.50 ALLOWANCE 140P0 HAUL /DISPOSE 25,000.001 14,794.00 0.001 0.001 14,794.001 59.18%1 10,206.00 1,479.40 AIA Document G703T" —1992. Copyright O 1963, 1965, 1966, 1967,1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be 2 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 14:53:10 on 12/11/2009 under Order No.07542409 which expires on 0511012010, and is not for resale. User Notes: (1650865743) A B C D E F G H 1 WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY COMPLETED BALANCE TO RETAINAGE PREVIOUS STORED AND STORED TO FINISH (IF VARIABLE NO. WORK VALUE APPLICATION THIS PERIOD DATE (G C) (C G) RATE) (NOT IN D OR E) (D+E +F) (D E) UNSUITABLE MATERLAL ALLOWANCE -6 OZ. GEOTECH. 140Q1 FABRIC 4,700.00 3,207.00 0.00 0,00 3,207.00 68.23% 1,493.00 320.70 ALLOWANCE- 140Q2 TENSAR GEOGRID 8,500.00 0.00 0.00 0.00 0.00 0.00% 8,500.00 0.00 ALLOWANCE42 140RO STONE 26,200.00 10,275.00 0.00 0.00 10,275.00 39.22%1 15,925.00 1,027.50 ALLOWANCE CABLE PASS 140S0 THRU (FOH) 6,456.00 0.00 0.00 0.00 0.00 0.00% 6,456.00 0.00 ALLOWANCE- CABLE PASS 140T0 THRU (BOH) 5,165.00 0.00 0.00 0.00 0.00 0.00% 5,165.00 0.00 ALLOWANCE- 140U CABLE PASS- 0 THRU (FLOOR) 17,217.00 0,00 0.00 0.00 0.00 0.00% 17,217.00 0.00 ALLOWANCE- TEMPORARY ELEVATOR 140VO USAGE 200,000.00 0.00 2,175.00 0.00 2,175.00 1.09 %1 197,825.00 0.00 ALLOWANCE 140W DONOR 0 RECOGNITION 100,000.00 0.00 100,000.00 0.00 100,000.00 100.00% 0.00 0.00 GENERAL 140X0 ALLOWANCE 400,000.00 5,980.00 125,000.00 0.00 130,980.00 32.75% 269,020.00 598.00 ALLOWANCE -AS- 140Y0 BUILD /CAD 5,000.00 0.00 0.00 0.00 0.00 0.00% 5,000.00 0.00 FIELD OFFICE /STORAGE 01501 TRAILER -M 16,400.00 14,200.00 500.00 0.00 14,700.00 89.63% 1,700.00 1,320.00 01502 FIELD 5,500.00 4,450.00 200.001 0.001 4,650.00 84.55% 850.00 405.00 AIA Document G703 1992. Copyright 1963, 1965, 1966, 1967,1970, 1978, 1983 and 1992 by The American institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be 3 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 14:53:10 on 12111/2009 under Order No.07542409 which expires on 05110/2010, and is not for resale. User Notes: (1650865743) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS STORED AND STORED TO FINISH (1F VARIABLE APPLICATION THIS PERIOD DATE (G C) (C G) RATE) (D E) (NOT IN D OR E) (D +E +F) OFFICE /STORAGE TRAILER -L TEMPORARY TOILETS /WASHIN 01503 G STATIONS -M 41,800.00 32,600.00 1,000.00 0.00 33,600.00 80.38% 8,200.00 2,860.00 TEMPORARY TOILETS /WASHIN 01504 G STATIONS -L 7,600.00 6,050.00 150,00 0.00 6,200.00 81.58% 1,400.00 555.00 FIRE PROTECTION /EME 01505 RG.STATIONS -M 19,300.00 19,300.00 0.00 0.00 19,300.00 100.00 0.00 1,930.00 FIRE PROTECTION/EME 01506 RG.STATIONS -L 4,000.00 3,400.00 0.00 0.00 3,400.00 85.00% 600.00 310.00 FURNISH/MAINTA 01507 IN TRASH CANS -M 6,000.00 6,000.00 0.00 0.00 6,000.00 1.00.00 0.00 600.00 FURNISH/MAINTA 01508 IN TRASH CANS -L 40,000.00 27,500.00 1,200.00 0,00 28,700.00 71.75% 11300.00 2,350.00 TEMPORARY ROAD/MAINTENA 01510 NCE 148,000.00 132,600.00 0.00 0.00 132,600.00 89.59% 15,400.00 12,220.00 TEMPORARY FENCING REMOVE/RELOCA 01520 TE 15,800.00 15,800.00 0.00 0.00 15,800.00 100.00% 0.00 1,580.00 TEMPORARY 01521 FENCING -GATES 6,500.00 6,500.00 0.00 0.00 6,500.00 100,00%1 0.00 650.00 TEMPORARY FENCING 01522 SCREENING 8,744.00 8,744.00 0.00 0.00 8,744.00 100.00% 0.00 874.40 TEMPORARY 01523 BARRIERS -M 6,800.001 6,800.00 0.00 0.00 6,800.00 100.00% 0.00 680.00 01524 ITEMPORARY 7,500.00 7,500.00 0.00 oml 7,500.001 100.00 %1 0.00 750.00 AIA Document G703T -1992. Copyright 1963, 1965, 1966, 1967,1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AlA 111 Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be 4 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 14:53:10 on 12111/2009 under Order No.0754240912_1 which expires on 05110/2010, and is not for resale. User Notes: (1650865743) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO FINISH (IF VARIABLE (G C) APPLICATION DATE (C G) RATE) (D E) (NOT IN D OR E) (D +E +F) BARRIERS -L TEMPORARY 01530 ENCLOSURES -M 10,800.00 10,800.00 0.00 0.00 10,800.00 100.00 0.00 1,050.00 TEMPORARY 01.531 ENCLOSURES -L 14,000.00 14,000.00 0.00 0.00 14,000.00 100.00 0.00 1,360.00 SCAFFOLDING SET UP /CONSUMABLE 01540 S 398,0K00 398,000.00 0.00 0.00 398,000.00 100.00 0.00 37,620.00 SCAFFOLDING MONTHLY RENTALANSPECTI 01541 IONS 228,000.00 142,500.00 19,000.00 0.00 161,500.00 70.83%1 66,500.00 10,450.00 SCAFFOLDING DISMANTLE /REM 01542 OVE 55,000.00 0.00 0.00 0.00 0.00 0.00 55,000.00 0.00 STAIR TOWERS 01543 SETUP 54,000.00 18,000.00 0.00 0.00 18,000.00 33.33% 36,000.00 1,800.00 STAIR TOWERS MONTHLY 01544 IRENTAL 28,500.00 7,500.00 2,000.00 0.00 9,500.00 33.33 %1 19,000.00 350.00 STAIR TOWERS 01545 DISMANTLE 6,700.00 0.00 0.00 0.00 0.00 0.00 6,700.00 0.00 HOIST- EXTERIOR- 1546.1 SET UP 17,000.00 0.00 0.00 0.00 0 .00 0.00% 17,000.00 0.00 HOIST- EXTERIOR- RENTAL/OPERATI 1546.2 ON 242,500.00 0.00 0.00 0.00 0.00 0.00% 242,500.00 0.00 HOIST- EXTERIOR- 1546.3 DISMANTLE 5,500.00 0.00 0.00 0.00 0.00 0.00% 5,500.00 0.00 HOIST- STAIR2 -SET 1547.1 UP 17,000.00 0.00 0.00 0.00 0.00 0.00% 17,000.00 0.00 AIA Document G703TM 1992. Copyright 1963, 1965, 1966, 1967,1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be 5 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 14:53:10 on 12/1112009 under Order No.0754240912_ which expires on 0511012010, and is not for resale. User Notes: (1650865743) A B C D E F G H l WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS STORED AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD (NOT IN D OR E) DATE {G C) (C G) RATE) (D E) (D +E +F) HOIST -STAIR 2- RENTAL/OPERATI 1547.2 ON 242,500.00 0.00 0.00 0.00 0.00 0.00% 242,500.00 0.00 HOIST -STAIR 2- 1547.3 DISMANTLE 5,500.00 0.00 0.00 0.00 0.00 0.00% 5,500.00 0.00 HOIST -ROOM 100- 1548.1 SET UP 95,000.00 95,000.00 0.00 0.00 95,000.00 100.00% 0.00 9,500.00 HOIST -ROOM 100 RENTAL/OPERATI 1548.2 ON 211,000.00 182,750.00 4,500.00 0.00 187,250.00 88.74%1 23,750.00 16,975.00 HOIST -ROOM 100- 1548.3 DISMANTLE 2,500.00 0.00 0.00 0.00 0.00 0.00 2,500.00 0.00 HOIST ALLOWANCE -SET 1549.1 UP 75,000.00 0.00 0.00 0.00 0.00 0.00% 75,000.00 0.00 HOI ST- ALLOWANCE- RENTAL/OPERATI 1549.2 ON 88,000.00 0.00 0.00 0,00 0.00 0.00% 88,000.00 0.00 HOIST- ALLOWANCE- 1549,3 DISMANTLE 2,500.00 0.00 0.00 0.00 0.00 0.00% 2,500.00 0.00 01556 TRASH CHUTES -M 52,000.00 47,300.00 0.00 0.00 47,300.00 90.96% 4,700.00 4,490.00 01557 TRASH CHUTES -L 58,000.00 34,000.00 4,000.00 0.00 38,000.00 65.52% 20,000.00 2,500.00 GENERAL CLEAN 01560 UP -M 5,000.00 3,440.00 300.00 0.00 3,740.00 74.80% 1,260.00 314.00 GENERAL CLEAN 01561 UP -L 60,000.00 39,600.00 3,000.00 0.00 42,600.00 71.00% 17,400.00 3,560.00 01562 FINAL CLEANING 65,000.00 0.00 0.00 0.00 0.00 0.00% 65,000.00 0.00 EXCAVATION /BA 02110 CKFILL- SUMPS -M 12,019.00 12,019.00 0.00 0.00 12,019.00 100-00% 0.00 1,201.90 02111 EXCAVATION /BA 25,000.001 25,000.00 0.001 0.00 25,000.001 100.00%1 0.00 2,500.00 AIA Document G703 1992. Copyright 0 1963, 1965, 1966, 1967,1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be 6 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 14.53. 10 on 12/11/2009 under Order No.0754240912_1 which expires on 0511012010, and is not for resale. User Notes: (1650865743) A B C D E F G H K COMPLETED WORK TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY WORK VALUE PREVIOUS STORED AND STORED TO FINISH (IF VARIABLE NO. APPLICATION (NOT IN D OR E) THIS PERIOD DATE (G C) (C G) RATE} (D E) (D +E +F) CKFILL- SUMPS -L EQ 02240 SHORING 209,800.00 209,800.00 0.00 0.00 209,800.00 100,00% 0.00 20,980.00 CAST IN PLACE 03301 CONCRETE -M 12,000.00 12,000.00 0.00 0.00 12,000.00 100.00% 0.00 1,000.00 CAST IN PLACE 03302 CONCETE -L 40,000.00 40,000.00 0..00 0.00 40,000.00 100.00% 0.00 3,500.00 PRECAST PLANKS -12" 03410 HOLLOW CORE 161,000.00 161,000.00 0.00 0.00 161,000.00 100.00% 0.00 1.6,100.00 PRECAST PLANKS -1.2" 03411 ISOLID 898,000.00 898,000.00 0.00 0.00 898,000.00 100.00% 0,00 89,800.00 PRECAST 03412 PLANKS -6" SOLID 107,000.00 107,000.00 0.00 0.00 107,000.00 100,00% 0.00 10,700.00 PRECAST 03413 TRUCKING 82,000.00 82,000.00 0.00 0.00 82,000.00 100.00% 0.00 8,200.00 PRECAST 03414 ERECTION 186,000.00 186,000,00 0.00 0.00 186,000.00 100.00%1 0.00 18,600.00 INTERIOR METAL FABRICATIONS 05504 SUBMITTALS 102,000.00 102,000.00 0.00 0.00 102,000.00 100.00% 0.00 10,200.00 STEEL STAIRS 05505 WITH RAIL -M 179,000.00 179,000.00 0.00 0.00 179,000.00 100.00% 0.00 14,857.00 STEEL STAIRS 05506 WITH RAIL -L 80,000.00 73,000.00 0.00 0,00 73,000.00 91.25% 7,000.00 6,600.00 05507 LADDERS -M 26,000.00 26,000.00 0.00 0.00 26,000.00 100.00% 0.00 2,600.00 05508 LADDERS -L 12,500.00 12,500.00 0.00 0.00 12,500.00 100.00% 0.00 1,220.00 CATWALK 05509 FRAMING -M 63,000.00 63,000.00 0.00 0.00 63,000.00 100-00% 0.00 6,300.00 CATWALK 05510 FRAMING -L 28,000-001 28,000.00 0.00 0.00 28,000.00 100.00 0.00 1,710.00 AIA Document G703- -1992. Copyright 1963, 1965, 1966, 1967,1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be 7 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 14:53.10 on 12/1112009 under Order No.0754240 which expires on 05/10/2010, and is not for resale. User Notes: (1650865743) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRI_I'TION OF SCHEDULED FROM PRESENTLY NO. WORD VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE THIS PERIOD STORED DATE {G C) (C G) RATE) APPLICATION (NOT IN D OR E) (D E) (D +E +F) MISCELLANEOUS 05511 METALS-M, 441,000.00 260,550.00 150,000.00 0.00 410,550.00 93.10 30,450.00 13,615-00 MISCELLANEOUS 05512 METALS -L 275,000.00 162,250.00 100,000.00 0.00 262,250.00 95,36% 12,750.00 8,094.30 INTERIOR ROUGH 06100 CARPENTRY -M 31,000.00 10,320.00 0.00 0.00 10,320.00 33.29% 20,680.00 372.00 INTERIOR ROUGH 06101 CARPENTRY -L 44,000.00 13,640.00 0.00 0.00 13,640.00 31.00%1 30,360.00 484.00 FOUNDATION WATERPROOFING 07110 -M 5,100.00 5,100.00 0.00 0.00 5,100.00 100.00% 0.00 510.00 FOUNDATION WATERPROOFING 07111 -L 6,600.00 6,600.00 0.00 0.00 6,600.00 100.00% 0.00 660.00 07210 DUCT LINERS -M 97,000.00 97,000.00 0.00 0.00 97,000.00 100.00%1 0.00 9,700.00 07211 DUCT LINERS -L 28,000.00 28,000.00 0.00 0.00 28,000.00 100.00% 0.00 1,120.00 07810 FIRESTOPPING -M 24,000.00 16,800.00 0.00 0.00 16,800.00 70.00% 7,200.00 1,680.00 07811 FIRESTOPPING -L 16,000.00 12,200.00 0.00 0.00 1.2,200.00 76.25% 3,800.00 1,220.00 JOINT SEALANTS 07910 M 35,000.00 0.00 0.00 0.00 0.00 0.00%, 35,000.00 0.00 JOINT SEALANTS 07911 L 80,000.00 0,00 0.00 0.00 0.00 0.00% 80,000.00 0.00 STEEL DOORS 08110 FRAMES -M 73,000.00 71,500.00 0.00 0.00 71,500.00 97.95% 1,500.00 6,230.00 STEEL DOORS 08111 FRAMES -L 33,000.00 24,550.00 0.00 0.00 24,550.00 74.39% 8,450.00 825.00 FLUSH WOOD 08140 DOORS -M 39,000.00 780.00 0.00 0.00 780.00 2.00% 38,220.00 78.00 FLUSH WOOD 081.41 DOORS -L 15,000.00 0.00 0.00 0.00 0.00 0.00% 15,000.00 0.00 STILE RAIL 08143 WOOD DOORS -M 127,000-00 0.00 0.00 0.001 0.00 0,00% 127,000.00 0.00 AIA Document G703T 1992. Copyright 0 1963, 1965, 1966, 1967,1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be 8 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 14:53:10 on 12111/2009 under Order No.0754240912_1 which expires on 05/10/2010, and is not for resale. User Notes: (1650865743) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM. PRESENTLY NO. WORK VALUE PREVIOUS STORED AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD DATE (G. C) (C G) RATE) (D E) (NOT IN D OR E) (D +E +F) STILE RAIL 08144 WOOD DOORS -L 34,000.00 2,540.00 0.00 0.00 2,540.00 7,47% 31,460.00 254.00 SOUND CONTROL DOORS 08347 WINDOWS -M 352,000.00 9,000.00 0.00 0.00 9,000.00 2,56% 343,000.00 900.00 SOUND CONTROL DOORS 08348 WINDOWS -L 50,000.00 0.00 0.00 0.00 0.00 0.00% 50,000.00 0.00 OVER COILING 08355 DOORS -M 20,750.00 0.00 0.00 0.00 0.00 0.00 20,750.00 0.00 OVERHEAR 08356 COILING DOORS -L 2,850.00 0,00 0.00 0.00 0.00 0,00%1 2,850.00 0.00 ALUM.FRAMED ENTRANCES /STOR 08410 EFRONTS -M 1.76,000.00 29,520.00 0.00 0,00 29,520. 16.77% 146,480.00 352.00 ALUM.FRAMED ENTRANCES /STOR 08411 EFRONS -L 69,700.00 0.00 0.00 0.00 0.00 0.00% 69,700.00 0.00 INTERIOR ALUM. DOORS 08413 FRAMES -M 17,000.00 340.00 0.00 0.00 340.00 2.00%1 16,660.00 34.00 INTERIOR ALUM. DOORS 08414 FRAMES -L 6,000.00 0.00 0.00 0.00 0.00 0,00% 6,000.00 0.00 REVOLVING DOOR 08423 ENTRANCES -M 69,00000 1,380,00 0.00 0.00 1,380.00 2.00% 67,620.00 138.00 REVOLVING DOOR 08424 ENTRANCES -L 9,500.00 0.00 0.00 0.00 0.00 0.00% 9,500.00 0.00 GLAZED ALU,. CURTAIN WALLS 08440 IM 1 325,000.00 147,000.001 0ml 0.001 147,000-001 45,23%1 178,000.001 11,375.00 AIA Document G703- -1992. Copyright© 1963, 1965, 1966, 1967,1970, 1979, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIO Document, or any portion of it, may result in severe civil and criminal penalties, and will be 9 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 14:53:10 on 1 2/1 11200 9 under Order No.07542409 which expires on 0511012010, and is not for resale. User Notes: (1650865743) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS THIS PERIOD STORED (G C) AND STORED TO FINISH (IF VARIABLE APPLICATION (NOT IN D OR E) DATE (C G) RATE) (D E) (D +E +F) GLAED ALUM. CURTAIN WALLS 08441 L 148,000.00 6,000.00 5,500.00 0.00 11,500.00 7.77% 136,500.00 0.00 08710 HARDWARE 525,000.00 446 0.00 0.00 446,000.00 84.95%1 79,000.00 18,800.00 INTERIOR 08810 GLAZING -M 11,000.00 220.00 0.00 0.00 220.00 2.00 10,780.00 22.00 INTERIOR 08811 GLAZING -L 8,000.00 0.00 0.00 0.00 0.00 0.00 8,000.00 0.00 FIRE PROTECTION 10440 SPECIALTIES -M 7,580.00 0.00 0.00 0.00 0.00 0.00% 7,580.00 0.00 FIRE PROTECTION 10441 SPECIALTIES -L 1,800.00 0.00 0.00 0.00 0.00 0,00% 1,800.00 0.00 10450 KNOX BOX 650.00 0.00 0.00 0.00 0.00 0,00% 650.00 0.00 LOADING DOCK 111.30 EQUIPMENT -M 18,500.00 16,475.00 0,00 0.00 16,475.00 89.05% 2,025.00 1,647.50 LOADING DOCK 11131 EQUIPMENT -L 3,800.00 2,200.00 0.00 0.00 2,200.00 57.89%1 1,600.00 220.00 ELEC.TRACTION ELEVATORS 14210 JENGf.NEERING 157,200.00 157,200.00 0.00 0.00 157,200.00 100.00% 0.00 15,720.00 ELEC.TRACTION ELEVATORS MATERIAL /EQUIP 14211 MENT 452,000.00 452,000.00 0.00 0.00 452,000.00 100.00% 0.00 40,000.00 ELEC.TRACTION 14212 ELEVATORS -L 186,000.00 58,000.00 56,000.00 0.00 114,000.00 61.29 1 72, 000.00 0.00 HYDRAULIC ELEVATOR- 14241 ENGINEERING 69,500.00 69,500.00 0.00 0.00 69,500.00 100.00 0.00 6,950.00 HYDRAULIC ELEVATOR 14242 MATERIAL /EQUIP 183,000-001 183,000.00 0.00 0.00 183,000.00 100-00% 0.00 18,300.00 AIA Document G703- 1992. Copyright O 1963, 1965, 1966, 1967,1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this Ale Document, or any portion of it, may result in severe civil and criminal penalties, and will be 1 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 14:53:10 on 1211112009 under Order No.0754240912_ which expires on 05/10/2010, and is not for resale. User Notes: (1650865743) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM. DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO FINISH (IF VARIABLE APPLICATION DATE (G C} (C G) RATE) (D E) (NOT IN D OR E} (D +E +F) MENT HYDRAULIC ELEVATOR 14243 LABOR 63,000.00 63,000.00 0.00 0.00 63,000.00 100.00 0.00 6,300.00 WHEELCHAIR LIFT MATERIAL/EQUIP 14421 IMENT 48,000.00 0.00 0.00 0.00 0.00 0.00%1 48,000.00 0.00 WHEELCHAIR. 14422 LIFT PERMITS 2,200.00 0.00 0.00 0.00 0.00 0,00% 2,200.00 0.00 WHEELCHAIR 14423 LIFT -LABOR 14,000.00 0.00 0.00 0.00 0,00 0.00% 14,000.00 0.00 CHANGE ORDER 17001 NO. 01 228,000.00 228,000.00 0.00 0,00 228,000.00 1.00.00%1 0.00 450.00 CHANGE ORDER 17002 NO. 02 9,031.00 9,031.00 0.00 0.00 9,03L00 100.00 0.00 0.00 CHANGE ORDER 17003 NO. 03 2,196.00 300.00 0.00 0.00 300.00 13.66 1,896.00 30.00 17000 CHANGE ORDER 4 NO. 04 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 17000 CHANGE ORDER 5 NO. 05 98,741.00 98,741.00 0.00 0.00 98,741.00 100.00% 0.00 9,874.10 17000 CHANGE ORDER 6 NO. 06 17,527.00 17,527.00 0.00 0.00 17,527.00 100.00% 0.00 1,400.00 17000 CHANGE ORDER 7 NO. 07 11,292.00 11,292.00 0.00 0.00 1.1,292.00 100.00% 0.00 1,129.20 17000 CHANGE ORDER 8 NO. 08 44,936.00 44,936.00 0.00 0.00 44,936.00 100.00% 0.00 4,493.60 1.7000 CHANGE ORDER 9 NO. 09 14,683.00 14,683.00 0.00 0.00 14,683.00 100,00% 0.00 0.00 17001 CHANGE ORDER 0 NO. 10 760,330.00 0.00 750,573.00 0.00 750,573.00 98.72% 9,757.00 38,016.50 AIA Document G703T" -1992. Copyright C 1963, 1965, 1966, 1967,1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be 1 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 14:53:10 on 12111/2009 under Order No.07542409 which expires on 0511012010, and is not for resale. User Notes: (1650865743) A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY COMPLETED BALANCE TO RETAINAGE NO. WORK VALUE PREVIOUS STORED AND STORED TO FINISH (IF VARIABLE (NOT IN D OR E) APPLICATION THIS PERIOD DATE (C' C) (C G) RATE) (D E) (D +E +F) GRAND TOTAL 1 $11,901,076.00 $7,555,054.00 $392,930.001 $0.00 $7,947,984.001 66.78%1 $3,953,092.001 $595,053780 AIA Document G703T" —1992. Copyright 1963, 1965, 1966, 1967,1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be 12 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 14:53:10 on 12/11/2009 under Order No.07542409 which expires on 05/10/2010, and is not for resale. User Notes: (1650865743) AFFIDAVIT AND WAIVER OF LIEN ]FINAL X PARTIAL PAYMENT TO FOLLOW State of Indiana, County of Madison SS Bradley Tyler being duly sworn states that he is the Project Manager of W. R. Dunkin Son, Inc. having contracted with City of Carmel Redevelopment Commission to furnish certain materials and /or labor as follows: Bid Package 4050- General Trades for a project known as Parcel 7A, Carmel Regional Performing Arts Center located at Carmel, Indiana and owned by City of Carmel and does hereby further state on behalf of the aforementioned Contractor. Application for Payment 18 has been received for work performed through 10/31/09 (PARTIAL WAIVER) that there is due from the contractor the sum of Five Hundred Two Thousand Seven Hundred Forty -six dollars and 00 /cents 502,746.00 Application for Payment has been received for work performed through (FINAL WAIVER) that the final balance due from the Owner is the sum of dollars and 00 /cents 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 thereon on account of LABOR or material or both, furnished by the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certifies that no other party has any claim or right to a lien o count of any work performed or material furnished to the undersigned for said project a e s pe o affidavit nd waiver. W. R. Dunkin Son In B Title: Project Manager WITNESS MY HAND AND NOTARIAL SEAL, this 10 day of December _2009 e (Notary ublic) My Commission Expires: January 08, 2017 Printed Martha A. Carpenter Residing in Madison County Prescribed by State Board 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 G in kin S 01I T Y t Purchase Order No. P Bo 2-2 Terms A j�e)`SOh. ly �w0 Date Due Invoice Invoice Description Amount Date Number (or note attached invo or bill(s)) f 2. 7`i v' 20 7 e- &r 7� Total 3 ?7 7� So 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. (r�rr ALLOWED 20 IN SUM OF PO 22 q7 An -3erso ZY '46W 5772 5� ON ACCOUNT OF APPROPRIATION FOR Board Members Poi or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or WL 0 0 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 X d 201Q Si at e irectn� iy r W eveloprnee�4 Title Cost distribution ledger classification if claim paid motor vehicle highway fund 4 December 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 EMERGENCY WORK W. R. Dunkin Sons Invoice No. 08- 385 1509 -3 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 ($5,465.00). Sincerely, Warren David Brewer Project Manager cc: Don Cleveland Mike Anderson Tony Eisenhut File Work. r ["T �3 General Contractors Construction Managers Established 1915 P.O. Box 2247 PHONE (765) 643 3321 ANDERSON, IN 46018 FAx: (765) 778 -2970 INVOICE NO. 08-385-1509-3 DATE: 12/01/09 TO: City of Carmel Redevelopment Commission One Civic Square Carmel, IN 46032 RE: Project: Parcel 7A, Carmel Regional Performing Arts Center Additional Cost for Cleaning Water Control in Building Required to Mitigate Delay due to Shut -Down APPLICATION NO. 3 T &M for Bulletin #44 Cleaning Water Control to Mitigate Delay Impact Partial 5,465.00 TOTAL AMOUNT DUE i5A5.00 EW,9ehC WWk BULLETIN RESPONSE NO: 044 2911 Enterprise Drive PO Box 2247 Phone (765) 643 -3321 Anderson, IN 46018 -22.47 Fax (765) 778 -2970 Title: Cleaning and Water Control in Building Date: 12/1/2009 Required to Mitigate Delay due to Shut -Down Project: Carmel Performing Arts Center Project No: 08 -385 Detailed breakdowns are attached for review. The following is a summary of responses to this bulletin: Bid Package 4050- General Trades: $5,465 Bid Package 5010- Interior Finish: $0 TOTAL CHANGE PER THIS BULLETIN $5,465.00 ACTION REQUESTED OF ARCHITECT AND CONSTRUCTION MANAGER S6 Please note your response and sign below in the area provided. Please file for your reference. No further approval is required. Construction Manager's Response: Proceed as detailed in this Bulletin, A change order will be issued for the amounts noted. Revise and resubmit for additional review. Refer to the additional comments attached. Signed Shiel Sexton Company BULLETIN #44 z E 4 General Contractors R C;onstruetivn .Managers t;ranrir��� Ivt� December 1, 2009 Shiel Sexton Company, Inc. 902 North Capitol Avenue Indianapolis, IN 46204 ATTN: Dave Brewer PROJECT: Carmel Performing Arts Center RE: Bulletin #44 Cleaning and Water Control to Mitigate Delay Impact Partial Dave, As requested we have completed additional work to assist with cleaning and containing water inside the building so construction can continue following the shut -down. This change request includes the T &M work completed per Work Orders #513 and 514. A breakdown with supporting detail is attached for your reference. Total investment for completed work 5,465 Thank you for the opportunity to complete the additional work noted. Please call if you have any questions. Yours very truly, W. R. DUNKIN SON, INC. 'Bradley Tyle Project Manager 'lbSEV �GG 2409 WEST 1 8 STREET PO BOX 2247 ANDERSON, IN 46018 -2247 765 643 -3321 FAX 765 -642 -7679 Bulletin 44 Estimate Page 1 Carmel Regional Performing Arts Center Material Equipment Quoted Labor Subcontract Description Quantity Unit FUnit Cost Total Cost I Material Cost Unit MH Total MH Rate Total Cost Unit Cost Total Cost Total Cost T &M WORK FOR WATER CONTROL (PARTIAL) REQUIRED TO MITIGATE SHUT -DOWN DELAY Includes Work Orders #513 514 0.000 $0.00 MATERIAL 0.000 $0.00 Lowe's Invoice 1 Ticket 1 Sum 30.64 0.000 $0.00 31 SESCO 1 Ticket 1 Sum 189.96 0.000 $0.00 190 0.000 $0.00 LABOR 0.000 $0.00 Superintendent 7 MH 1.000 7.00 $63.00 441 441 Superintendent 1 MH 1.000 1.00 $94.50 95 95 Carpenter Straight Time 68 MH 1.000 68.00 $51.53 3,504 3,504 Carpenters Time and One Half 1 MH 1.000 1.00 $77.30 77 77 Laborers Straight Time 16 MH 1.000 16.00 $35.46 567 567 Cement Finisher MH 1.000 $47.54 Truck Driver (Pick -up Barrels) HR 45.00 1.000 $51.53 Project Manager MH 1.000 $82.00 Estimator MH 1.000 $54.50 0.000 $0.00 SUBCONTRACTOR 0.000 $0.00 0.000 $0.00 0.000 $0.00 0.000 $0.00 Account Subtotal 221 93.00 4,684 4,905 Tax 0% Account Total 221 4,684 4,905 Estimated Material Quoted Material 221 Estimated Labor 4,684 Subtotal Material Labor 4,905 Quoted Subcontracts Subcontract Insurance Subtotal Quoted Work Project Subtotal 4,905 Overhead Profit -Mat'I Labor 10.0% 490 Overhead Profit Subcontracts 10.0% SUB TOTAL 5,395 Bond 1.3% 70 TOTAL 5,465 Printed 12/1/2009 Pagel DUNKIN WORK ORDER Son, Inc. NO. .9 General Contractors Construction Managers Established 19" P.O. Box 2247 Anderson, IN 46018 Telephone (765) 643 -3321 Fax (765) 778 -2970 Date NOVI Job No. DESCRIPTION OF WORK: L)? at4l) 6ar1Z0t✓ Job Name Cost Code o Extra Mme Material o Backcharge o Other *This work has has not C- JCS Z been completed. OR TRADE HOURS ST OT RATE TOTAL IRA tj I /U X1/13 C619 "k- Ot BuT 5e'gg'5 I &k? L gi g f /L3 1l z l i3 g Aj Miff OTY MATERIAL (Note where purchased or from stock) EQUIPMENT HOURS 5C S60 72, 32 Small Tools W.R.D. Truck WORK AUTHORIZED BY: ACKN' GEMENT. Company W. .D. Representative By Title White W.R.D. File Yellow Customer Pink Job File' WORK ORDER K1 IT N -N 4 Son. Ine. NO. .J i Cenral Contractors Construction Managers Fstablished 1915 P.O. Box 2247 Anderson, IN 46018 �e� Telephone (765) 643 -3321 Fax (765) 778 -2970 Date nh M 0 7 Job No JQS DESCRIPTION OF WORK: AVO &1/77U Job Name OkAfl' Cost Code 1 o Extra �me Material o Backcharge o Other *This work has has not S-5L 30, /zo been completed. LABOR TRADE HOURS ST OT RATE TOTAL t 1 6 )a L ARX v r-t I zo L QTY MATERIAL (Note where purchased or from stock) EQUIPMENT HOURS Small Tools W.R.D. Truck WORK AUTHORIZED BY: DGEMENT: Company W.R.D. Representative T ll �.oq By Title White W.R.D. File Yellow Customer Pink Job File IN P Remit to Address Southeastern Supply Co., Inc. 4325 Prospect Street Southeastern Supply Co. Indianapolis, IN 46203 4325 Prospect Street Indianapolis, IN 46203 Telephone: 317-359-9551 Facsimile: 317-359-0176 Page 1 of I Invoice No: 296300 Invoice Date: 11119109 Sales Order No: 720328 INV OICE-TO W.R. Dunkin Son, Inc. Customer No: 6005 P.O. Box 2247 Customer Purchase Order. 385 Sales Person Name: David Brown Anderson, IN 46018- Order Date: 11/17/09 Ship Date: 11/17/09 Delivery Note No: 720328 Shipping Instructions: SESCO TRUCK 11 PM P Pri C 03THOR003 Waterplug 5 Gal. EA 4 4 0 47.49 189.96 Gross TOM FreighV` Miscellaneous D iscoUntr 189.96 0.00 0.00 0.00 0.00 189.96 LoWE LOWE'S HOME CENTERS, INC. 14598 LOWES WAY CARMEL, IN 46033 (317)566 -8124 -SALE SALES S1525RW2 1178699 11 -16 -09 13617 120Z FOAM GAPS AND CRACK 28.64 8 3.58 SUBTOTAL: 28.64 TAX: 2.00 INVOICE 02329 TOTAL: 30.64 BALANCE DUE: 30.64 LAR: 30.64 LAR XXXXXXXXXXXX7984 000751 LAR P0: 1509 ACCOUNT NAME: W R DUNKIN SONS INC AUTH BUYER: BROWNING DAVE AMOUNT: 30.64 ACCOUNT WILL BE BILLED UPON MERCHANDISE RECEIPT OR NO LATER THAN 60 DAYS FROM TRANSACTION DATE FOR STOCK MERCHANDISE AND NO LATER THAN 90 DAYS FROM TRANSACTION DATE FOR SOS OR DIRECT DELIVERY MERCHANDISE. Prescribed by State Board 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. n 1 Payee V R Qm K I h S o n, l h C, Purchase Order No. Po 9 oX 2-2'i_7 Terms Ana �trsn /V 14 01 8 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 12 —o1 -d nB 385 (sod 3 1 ti✓ nm r r C S 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 w R �L. nkin .Soh, Z nc IN SUM OF P� you 124 Wersoh,I IV 'ON ACCOUNT OF PPROPRIATION FOR �1oz N 7 Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 1132 03 -3P5- Iso9 -3 44609 5 1 465 Ud 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 l/ 2 -2 6- 2010 o WoMP �fA®development Title Cost distribution ledger classification if claim paid motor vehicle highway fund V