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188150 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 364048 Page 1 of 1 ONE CIVIC SQUARE GIBRALTAR CONSTRUCTION CORP CARMEL, INDIANA 46032 2932 N. WEBSTER AVENUE CHECK AMOUNT: $55,515.fi0 INDIANAPOLIS IN 46219 CHECK. NUMBER: 188150 CHECK DATE: 712 212 01 0 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460807 001 34,335.00 PERFORMING ARTS CENTE 902 4460807 002 21,180.60 PERFORMING ARTS CENTE 1 TM D U 1{ D ocument Uell Ulti o tl 992 f• Application and Certificate for Payment Construction Manager Adviser Edition Tn ntntMCD• "Or ceCT: Regional Performing Arts Ctr APPLICATION NO: 001 Distribution to: Carmel Redevelopment Comission 211 City center D rive PERIOD TO: 05/25/10 OWNER 30 W. Main Street, Suite 220 Carmel, IN 46032 Carmel, IN 46032 CONSTRUCTION MANAGER t*KUM UUN I KAU I U K: VIA IONSTRUCTION MANAGER: CONTRACT DATE: 04 13/10 ARCHITECT Gibraltar construction Corp PROJECT NOS: I I CONTRACTOR 2932 N. Webster Ave. Indianapolis, IN 462i9 VIA ARCHITECT: eso Architects, Inc. FIELD CONTRACT FOR: Hardscape Package P6 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that 16 he best of the Contractor'~ knowledge, information and Application is made for payment, as shown below, in connection with the Contract, belief the Work covered by this Applic; ion for Payment has been completed in accordance with the Continuation Sheet. AIA Document G703, is attached. Contract Documents, that all amounts 11 ve cen paid by the Contractor for Work for which previous 1,260,000.00 Certificates for Payment were iss ted an payments received from the Owner. and that current 1. ORIGINAL CONTRACT SUM payment shown herein is now due 2. Net change by Change Orde S ao CONTRACTOR Gibraltar C i n Corp 3. CONTRACT SUM TO DATE (Line I 2)_..._ 260.000.00 By: Date: /p 4. TOTAL COMPLETED STORED TO DATE (Column G on G703) 30,150.00 State of- �yV��pn,�, BRIAN R, MCBRIDE 5. RETAINAGE: County of: A aJe i r --y a. 1n of Cnn1 Ic1ed Work (Column 2 Res. fll Ha.% K 00 j.I P me thi s Subscribe �on 1 bolo �y Comm. Exp. '2 (Column D +Eon G703) me this of b• of Stored Material Notary Public: DI Commission 6 11 862 (Column Pon G703) My Commission expires: Total Retainage (Lines 5a +5b or Total in Column I of G703)., CERTIFICATE FOR PAYMENT 34,33S.00 In accordance with the Contract Documents, based on on -site observations and tile data comprising 6. TOTAL EARNED LESS RETAINAGE S this application, the Construction Manager and Architect certify to the Owner that to file best of their (Line 4 Less Line 5 Total) 00 knowledge, in Formation and belief the Work has progressed as indicated, the quality of the Work is in 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 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 an AMOUNT CERTIFIED 9. BALANCE TO FINISH, (Attach eanlan ion if autaant certified differs fr•rnrt the anionic applied. Initial rill frgu res tar this INCLUDING RETAINAGE I Application an nn due Co ti- nuati-on Sheet that arc: changed to conform with the aumrmt c�er fiJied.) 1.,233;665.00 (Line 3 less Line 6) S CONSTRUCT MAN E By: Date: 1. Z$ ZO I 0 ADDITIONS DEDUCTIONS i c e, Inc. CHANGE ORDER SUMMARY ARCHITECT: C Total changes approved in previous months by Owner By: Date: nn Total approved this Month S on This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS named herein. Issuance. payment and acceptance of payment are without prejudice to any rights of .00 NET CFIANGES by Change Order b 00 the Owner or Contractor under this Contract. CAUTION: You, should sign an original AIA Contract Document, on which'thislext appears in RED. Amoriginal assures that Changes will not be obscured. AIA Document G7021CMana -1992. Copyright O 1992 by The American Institute of Architects. All rights reserved. WARNING: This A10, Qocument Is protected by U.S. Copyright Law and Internatlonal Tr'ealles.. Unauthorized "reproduction or distribution :of.this.AIA @_Document, or any portion of if, may result in severe civil and,griminal penalties, and witl be prosecuted to the maxlrnum'extent posslbfp under the .Iaw. Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AIA Contract Documents, a -mall The American Institute of Architects' legal counsel, copyright @aia.org. CONTINUATION SHEET AIA DOCUMENT G70 (Instructions-on reverse side) PAGE -3 PAGE; AIA. Document G702 APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: containing Cone r-.tcior's signed Certification, is attached. APPLICATION DATE: 001 DS /zs /10 In tabulation's below, amounts are smied .to the neareSI, dollar. PERIOD TO: 05/25/10 Use Column I on Contracts where triable retainuge for line 'items may-apply. ARCHITECT'S PROJECT NO.: A U C D E F G li i XVORK COMPLE r D MATERIALS TOTAL BALANCE PRESENTLY COMPLETED RETAINAGE ITEt1 SCHEDULED FROM "PREVIOUS TO (IF VARIABLE) NO. DESCRIPTION OFA\VORK VALur STORED AND STORED G C) APPLICATION TI-itS 1'F RlOd (NO'[' IN TO. DATE FINISH RATE) (D E) D,OR E) (D +E` +1 (C G) 0001 Concrete Allowance 35,000_..00 .00 :00 .00 _00 .00 35,000,.00 .00 0002 :Motorcoach connect int. Allow 25.,000.,00 ..00 .00. ..0.0 ;00 .00 25,000_00 .00 0003 'Motorcoach Connect Ext. Allow .25,000,.00 ,00 .00. .'00 .00 25,000 .00 0004 Allowance 100 CY'Stone 4,500 -00 .00 .00 .00 ,00 .00 4,500.00 .00 0005 Allowance 5000 SP Geogrid. 3;500.00 .00 .00. .00 .00 .00 3,-500.00 .00 .0006 ,Allow. 30 Galvanized Sleeves. 1,500.00 .00 .00 .00 ,.00 .00 1 .00 0007 Supervision 10,000..00 -.00 300.00 .00 300,00 3.00 9,700.00 30,00 0008 Bonds 19,940_00 .00' 19,940..00 .00 19, 940,.00 .00..00 .00 1,994.00 0009 Mobilization /Demobilization 1,.500..00 ..00. 750.00 .00 750..00 50100 750..00 75.00 0010 Submittals 12., 000.00 ..00 1.0,000.00 .00 10,800 -.00 90..,00 1,.200.00 1, 0011 Misc. General Conditions 12•,000..00 .00 360.00 .00 360.00 `3.00 11,640.00 36.00 0012 Rebar Material 7,.500..00 .00 .00 .00 .00 .�OO 7,500.00 .00 0013 Trench Drain 4,- 00D.OD .00.00 .00 .00 .00 4,000.00 .00 0014 Concrete Curbs a9,000.00 .00 .00 .00 ..00 .00 89,000.00 .OD 0015 concrete Walks /Slabs 93,000.00 .00 .00 .00 .00 .00 93,000.00 .00 0016 North,9tair 25,000!.00 .00 .00 .00 .00 .00 25,000.00 .00 0017 Sheet Waterproofing 12 000;00 ..DO .00 ,00 .00 .00 12,000.00 .DO .0018 Green.Roof Decomposed Granit 104;,50D.00 .00 .00 .00 .00 .00 104,500.00 .00 0019 Electrical 21,.000.00 .00 .00 .00 .00 .00 21,000.00 .00 0020 Earthwork. 240,500 ..00 6,000.00 _00 6,000 -00 2:49 234;SODzOO 600,00 0021 Site Signage 3.,000.00 .00 .00 .DO .00. .00 3,000.00 .00 0022 Joint Sealants 560_00 .00 .00 .00 ,00 -0o 560.00 .00 0023 Concrete Pavers 128,400 -00 .00 .00 :00 _00 .00 .128,400.,00 _00 0024 Permeable Pavers 31,200.00 .00 .00 .00 ..00 .00 31- ,200:00 ..00 0025 Porous Pavers 14,400.00 ♦00 _00 .00 .00 .00 14;400.00 .00 ,44 AiA DOCUMENT G703 CONTINUATION SHEET FOR G702 .1992 EDITION ALAS 9)t992 THE mNIERICAN INSTITUTE OF ARCHITECTS; 1735 NEW YORK �1 AVENur, N.W, VIASHINGt'ON „D.C. 20006-5292 WARNING: Unlicensed, phatocopying,violates U.S: copydghtlaws: and will subject the violator to Legal prosecution. G7E)3 -1992 ,:F A& CAUTION: You should use an original AiA document which has this caution printed in red. An original assures that changes will not be obscured as may occurwhen documents are reproduced. CONTINUATION SHEET AIA D OC U M EN T G703 (Instructions on reverse side) PACE _3 of -PAG[S AIA Document G702,' APPLICATION AND CER'rirlCATE FOR PAYMENT, APPLICATION NO.: 001 containing Contractor's signed ,Certification, is attached. APPLICATION DATE: os /25/10 In "tabulations below, amounts are stated to the nearest dollar. PERIOD TO: Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO 05/25/10 A B C D E F G 1.1 1 WORK. COMPLETED MATERIALS TOTAL PRESENTLY BALANCE COMPLETED RLT.AINAGG ITEM SCIiEDCILED TO FROM PREVIOUS AND STORED (IF VARIABLE) NO. DESCRIPTION OF' VALUE STORED G I C) FINISH APPLICATION THIS PERIOD (NOT IN TO DATE C G) RATE) (D E) D pR F) (D +E +F) 0026 Granite Havers 296 .00I .00 .00 ..00 ..00 296,000..00 .00 0027 Topsail 48,000..00 .00 .00 .00 .00 .00 48,000.00 .00 1,2fi8,.000.00 ..00 30,,150.00 .00 38,150.00 3.01 .1,229,850.00 3,815.00 ft10,' AEA DOCUMENT G703 CONTINUATION SFIFE'r FOR G702 1992 EDITION AIAe ©1992 THE AMERICtN.INSTrru w OF ARCHITFM. 1735 NEW YORK AVENUE, N.u'., WASHINGTON; D.C: 2000&5292 i WARNING: Unlicensed photocopying violates U.S. copyright laws and wilt subject the violator to legal prosecution. G703 -1992 CAUTION:'You should use an original AIA document which has this caution printed in red. An original assures that changes will not be obscured as may occur when documents are reproduced. T TM Document G7021CMa -1992 Application and Certificate for Payment Construction Manager- Adviser Edition TO OWNER: PPnJECT: Regional Performing Arts Ctr APPLICATION NO .0 Distribution to: Carmel Redevelopment Comission 211 City Center Drive PERIOD TO o6 /is o OWNER 30 W. Main Street, Suite 220 Carmel, IN 46032 Carmel, IN 46032 CONSTRUCTION MANAGER rKUM UUN I KAU l UK: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 04/13/10 ARCHITECT Gibraltar Construction Corp PROJECT NOS: 1 I CONTRACTOR 2932 N. Webster Ave. Indianapolis, IN 46219 VIA ARCHITECT: Cso Architects, Inc. FIELD CONTRACT FOR: Iiardscape Package Pe El CONTRACTOR'S APPLICATION FOR PAYMENT The undersi Contractor certifies that the best of the Contractor's knowledge, information and Application is made for payment, as shown below, in connection with the Contract. belief the Work covered by this Applica n for Payment has been completed in accordance with the Continuation Sheet, AIA Document G703, is attached. Contract Documents, that all a s h e been paid by the Contractor for Work for which previous 1,268,000,00 Certificates for Payment wer sued d payments received from the Owner, and that current. 1. ORIGINAL CONTRACT SUM payment shown herein is no 2. Net change by Change Orders CONTRACTOR: no Gibra n ru ion Corp 3. CONTRACT SUM TO DATE (Line I +,2) 1.268.000.00 By: Date: 4. TOTAL COMPLETED 8 ST,flRED TO DATE (Column G on G703) 61, 684.00 State of �hJ S. RETAI NAG E County of: /ate' t BRIAN R. MCBRlD 8. of Completed Work Subscribed and syvorn to befor (Column D +E on G703) 6,168.40 me this day of .�-s ��I 5 gCS• C1 H3f1COCK lJCJIi h� b• of Stored Material Notary Publi y COMM ED. 11 -29 -2017 (Column F on G703) My Commission expires: i,� CC ;nn 1 Total Retaina (Lines 5a 5b or Total in column I ofG703) CERTIFICATE FOR PAYMENT 55, 515.60 In accordance with the Contract Documents, based on on -site observations and the data comprising 6. TOTAL EARNED LESS RETAINAGE this application, the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in 34, 335.00 accordance with the Contract Documents, and the Contractor is entitled to 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT payment of the AMOUNT p Y CERTIFIED. (Line 6 from prior Certificate) 1 8. CURRENT PAYMENT DUE 23 380 AMOUNT CERTIFIED the amount 2 l 4� Y 9. BALANCE TO FINISH, INCLUDING RETAINAGE Appl cntion�andron�taf amount certified She from dt�amt> Initial call figures vn this s 7 1 212 484.40 g conform with c rt ec(.) (Linea less Line 6) CONST TION MA A By: Date: !J 1 49 su CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHIT c i c nc Total changes approved in previous months by Owner B Date: nn Total approvedAhis;Month An This Certificate is not iab e. The AMOUNT CERTIFIED is payable only to the Contractor no TOTALS named herein. Issua e "ayment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order 00 the Owner or Cont r under this Contract. CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be obscured. AIA Document G7021CMaTM 1992. Copyright 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIO 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. Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AIA Contract Documents, e -mail The American Institute of Architects' legal counsel, copyright @aia.org. TM �1 Document G7021CMa -1992 Instructions Application and Certificate for Payment Construction Manager Adviser Edition A. General Information AIA Document G7021CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition, is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner, but not as a constructor, and where multiple Contractors have direct Agreements with the Owner. Procedures for their use are covered in AIA Document A201 /CMa, General Conditions of the Contract for Construction, Construction Manager Adviser Edition, 1992 Edition. B. Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G7021CMa, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA). To report copyright violations of AIA Contract Documents, e -mail The American Institute of Architects' legal counsel, copyright @aia.org. C. Completing the G7021CMa Form After the Contractor has completed AIA Document G703, Continuation Sheet, summary information should be transferred to AIA Document G7021CMa, Application and Certificate for Payment, Construction Manager Adviser Edition. The Contractor should sign G7021CMa, have it notarized and submit it, together with G703, to the Construction Manager and Architect. The Construction Manager and Architect should review G7021CMa and G703 and, if they are acceptable, complete the Certificate for Payment on G702 /CMa, The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9,5 and 9.6 of A201 /CMa. They should then initial all figures on G7021CMa and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G702/CMa and G703 should be forwarded to the Owner. D. Completing the G703 Form Heading: This information should be completed to be consistent with similar information on AIA Document G7021CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition. Columns A, B C: These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted. The breakdown may be by sections'of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D: Enter in this column the amount of completed work covered by the previous application (columns D E from the previous application). Values from column F (Materials Presently Stored) from the previous application should not be entered in this column. Column E: Enter here the value of Work completed at the time of this application, including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored (column F). Column F: Enter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated'into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column. Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E (Work Completed This Period). Column G: Enter here the total of columns D, E and F. Calculate the percentage completed by dividing column G by column C. Column H: Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date). Column I: This column is normally used only for contracts where variable retainage is permitted on a line -item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G7021CMa form. Construction Change Directives: Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A2011CMa. E. Making Payment The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager and Architect on AIA Document G702 /CMa, Application and Certificate for Payment, Construction Manager Adviser Edition. The completed form contains the name and address of the Contractor. Payment should not be made to any other party unless specifically indicated on G7021CMa. 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. Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AIA Contract Documents, e -mail The American Institute of Architects' legal counsel, copyright@aia.org. r CONTINUATION SHEET AIA DOCUMENT G703 (Instructions on reverse side) PAGE a OF PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: 002 containing Contractor's signed Certification, is attached. APPLICATION DATE: 06/15/10 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 06/15/10 Use Column 1 on Contracts where variable rewinage for line items may apply. ARCHITECT'S PROJECT NO.: A B C D E F G H 1 WORK COMPLETED MATERIALS TOTAL BALANCE ITEM SCHEDULED PRESENTLY COMPLETED A RETAINAGE NO. DESCRIPTION OF WORK VALUE FROM PREVIOUS STORED AND STORED (IF VARIABLE) THIS PERIOD (NOT IN TO DATE G C FINISH RATE) (D E) D OR E) (D +E +F) (C G) 0001 Concrete Allowance 35,000.00 .00 10,894.00 .00 10,894.00 31.13 24,106.00 1,089.40 0002 Motorcoach Connect Int. Allow 25,000.00 .00 .00 .00 .00 .00 25,000.00 .00 0003 Motorcoach Connect Ext. Allow 25,000.00 .00 .00 .00 .00 .00 25,000.00 .00 0004 Allowance 100 CY Stone 4,500.00 .00 .00 .00 .00 .00 4,500.00 .00 0005 Allowance 5000 SF Geogrid 3,500.00 .00 .00 .00 .00 .00 3,500.00 .00 0006 Allow. 30 Galvanized Sleeves 1,500.00 .00 .00 .00 .00 .00 1,500.00 .00 0007 Supervision 10,000.00 300.00 700.00 .00 1,000.00 10.00 9,000.00 100.00 0008 Bonds 19,940.00 19,940.00 .00 .00 19,940.00 100.00 .00 1,994.00 0009 Mobilization /Demobilization 1,500.00 750.00 .00 .00 750.00 50.00 750.00 75.00 0010 Submittals 12,000.00 10,800.00 600.00 .00 11,400.00 95.00 600.00 1,140.00 0011 Misc. General Conditions 12 360.00 840.00 .00 1,200.00 10.00 10,800.00 120.00 0012 Rebar Material 7,500.00 .00 7,500.00 .00 7,500.00 J00.00 .00 750.00 0013 Trench Drain 4,000.00 .00 .00 .00 .00 .00 4,000.00 .00 0014 Concrete Curbs 89,000.00 .00 .00 .00 .00 .00 89,000.00 .00 0015 Concrete Walks /Slabs 93,000.00 .00 .00 .00 .00 .00 93,000.00 .00 0016 North Stair 25,000.00 .00 .00 .00 .00 .00 25,000.00 .00 0017 Sheet Waterproofing 12,000.00 .00 3,000.00 .00 3,000.00 25.00 9,000.00 300.00 0018 Green Roof Decomposed Granit 104,500.00 .00 .00 .00 .00 .00 104,500.00 .00 0019 Electrical 21,000.00 .00 .00 .00 .00 .00 21,000.00 .00 0020 Earthwork 240,500.00 6,000.00 .00 .00 6,000.00 2.49 234,500.00 600.00 0021 Site Signage 3,000.00 .00 .00 .00 .00 .00 3,000.00 .00 0022 Joint Sealants 560.00 .00 .00 .00 .00 .00 560.00 .00 0023 Concrete Pavers 128,400.00 .00 .00 .00 .00 .00 1.28,400.00 .00 0024 Permeable Pavers 31,200.00 .00 .00 .00 .00 .00 31,200.00 ,00 0025 Porous Pavers 14,400.00 .00 .00 .00 .00 .00 14,400.00 .00 AIA DOCUMENT G703 CONTINUATION SHEET FOR G702 1992 EDITION AIA° ©1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, NW., WASHINGTON, D.C. 20006-5292 WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. G703-1992 CAUTION: You should use an original ASA document which has this caution printed in red. An original assures that changes will not be obscured as may occur when documents are reproduced. CONTINUATION SHEET AIA DOCUMENT G703 (Instructions on reverse side) PAGE r 0& PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: 002 containing Contractor's signed Certification, is attached. APPLICATION DATE: 06/15/10 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 06/15/10 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO.: A B C D E F G H 1 WORK COMPLETED MATERIALS TOTAL BALANCE ITEM SCHEDULED PRESENTLY COMPLETED TO RETAINAGE NO DESCRIPTION OF WORK VALUE FR APPLICATION THIS PERIOD STORED A D SDAORFD (G C) FINIS14 (IF VARIABLE) (NOT IN C G) RATE) (D E) D OR F) (D +E +F) 0026 Granite Pavers 296,000.00 .00 .00 .00 .00 .00 296,000.00 .00 0027 Topsoil. 48,000.00 .00 .00 .00 .00 .00 48,000.00 .00 1,268,000.00 38,150.00 23,534.00 .00 61,684.00 4.86 1,206,316.00 6,168.40 �t�tttt AIA DOCUMENT G703 CONTINUATION SHEET FOR G702 1992 EDITION AIA° ©1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N W, WASHINGTON, D.C. 20006-5292 WARNING: Unlicensed photocopying violates V.S. copyright taws and will subject the violator to legal prosecution. G703-1992 CAUTION: You should use an original AIA document which has this caution printed in red. An original assures that changes will not be obscured as may occur when documents are reproduced. ISA Form 1 -402 IM AFFIDAVIT AND WAIVER OF LIEN FINAL PARTIAL PAYMENT TO FOLLOW State of Indiana, County of Marion, SS Michael Smith being duly sworn state that he is the President of Gibraltar Construction Corp having contracted with the Owner to furnish certain materials and 1 or labor for a project known as Parcel 7A, Regional Performing Arts Center Hardscape Package P8 and owned by Village Financial, LLC. and does hereby further state on behalf of the aforementioned contractor: (PARTIAL WAIVER) that there is due from the Owner the sum of Twenty One Thousand One Hundred Eighty and 60/100---- Dollars ($21,180.60) receipt of which is hereby acknowledged; or the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVER) that the final balance due from the Owner is the sum of Dollars receipt of which is hereby acknowledged; or the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of ch payment. THERFORE, the undersigned waives and releases unto the Ow r of said premises, any and all lien or claim whatsoever on the above described property and improvements thereon ac unt of LABOR or material or both, furnished by the undersigned thereto, subject to limitations of conditions res d herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work r or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Gibraltar Construction Corp By Title President 4 r V WITNESS MY HAND AND NOTORIAL 74, this 21st day of June, 2010. (Notary Public) BR: AN R, MCBRiDE 41 1579 INDIANA SugCpN AACTOIRS ASSOCIATION INCOROORAT(D �I�,�,ho aeeRmwoaurlwn �:�r =e My Ccmm EY;^ 11 -29 -2017 Rev ,o DIAL Ccmm,�s�cry r'i� 611r✓o2 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 l D r a ffi r c on SAP C� r-h Ce fb Purchase Order No. 2332. Al We k s4 r A ye Terms I 1 Q n d o f I q( 2/7 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 5 -25 -1 1-1 8PAC Wbcafiati 34335-00 C d rc f 2 2/ 1 10 0 0-60 Total SS Srt 5. �Q 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 Gf brdlfar C ohsfnc 1 !On Corp IN SUM OF 2932 N Vl/��sfer A ve. I 0Iq 55515:60 ON ACCOUNT OF APPROPRIATION FOR Pay from IT 902/ V40107 Board Members Pots or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 02- I I 1 pj 080 34 3 3S 0 bill(s) is (are) true and correct and that the 2 "090 7 materials or services itemized thereon for which charge is made were ordered and received except 2 0/0 Signature Direntor of Redevelopme Cost distribution ledger classification if Title claim paid motor vehicle highway fund