216437 01/15/2013 CITY 6if-CAtAnEL, INDIANA VENDOR: 366798 Page 1 of 1
ONE CIVIC SQUARE J.B.&M.J.M.OF INDIANA, INC
CARMEL, INDIANA 46032 710 N PLANKINGTON AVE SUITE 1200 CHECK AMOUNT: $77,300.00
MILWAUKEE WI 53203
CHECK NUMBER: 216437
CHECK DATE: 1/15/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
202 R4462864 26580 PENN 77, 300 . 00 PENN ROW
Form -9 Request for Taxpayer Give Form to the
(Rev.December 2011) Identification Number and Certification requester. Do not
Department of the Treasury send to the IRS.
Internal Revenue Service
Name(as shown on your income tax return)
J.B.&M.J.M.of Indiana,Inc.
N Business name/disregarded entity name,if different from above
a�
rn
m
c
Check appropriate box for federal tax classification:
°
y ❑ Individual/sole proprietor Q C Corporation ❑S Corporation ❑ Partnership El Trust/estate
CL c
u ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)►
o Exempt payee
2 --------------------------------
C
N
CL ❑ Other(see instructions)►
Address(number,street,and apt.or suite no.) Requester's name and address(optional)
U
710 N. Plankinton Avenue,Suite 1200
a) City,state,and ZIP code
a)
u) Milwaukee,WI 53203
List account number(s)here(optional)
Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on the"Name"line Social security number
to avoid backup withholding.For individuals,this is your social security number pag However,for a —IE —
resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other
entities,it is your employer identification number(EIN).If you do not have a number,see How to get a FM
TIN on page 3.
Note.If the account is in more than one name,see the chart on page 4 for guidelines on whose Employer identification number
number to enter.
3 5 — 2 0 1 2 0 2 5 1 6
Certification
Under penalties of perjury,I certify that:
1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me),and
2. 1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding,and
3. 1 am a U.S.citizen or other U:S.person(defined below).
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage
interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and
generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the
instructions on page 4.
Sign Signature of 9 7
Here U.S.person► Date► f �-
General Instructi S Note.If a requester gives you a form other than Form W-9 to request
your TIN,you must use the requester's form if it is substantially similar
Section references are to the Internal Revenue Code unless otherwise to this Form W-9.
noted. Definition of a U.S.person.For federal tax purposes,you are
Purpose of Form considered a U.S.person if you are:
A person who is required to file an information return with the IRS must •An individual who is a U.S.citizen or U.S.resident alien,
obtain your correct taxpayer identification number(TIN)to report,for •A partnership,corporation,company,or association created or
example,income paid to you,real estate transactions,mortgage interest organized in the United States or under the laws of the United States,
you paid,acquisition or abandonment of secured property,cancellation .An estate(other than a foreign estate),or
of debt,or contributions you made to an IRA.
•A domestic trust(as defined in Regulations section 301.7701-7).
Use Form W-9 only if you are a U.S.person(including a resident
alien),to provide your correct TIN to the person requesting it(the Special rules for partnerships.Partnerships that conduct a trade or
requester)and,when applicable,to: business in the United States are generally required to pay a withholding
tax on any foreign partners'share of income from such business.
1.Certify that the TIN you are giving is correct(or you are waiting for a Further,in certain cases where a Form W-9 has not been received,a
number to be issued),
partnership is required to presume that a partner is a foreign person,
2.Certify that you are not subject to backup withholding,or and pay the withholding tax.Therefore,if you are a U.S.person that is a
3.Claim exemption from backup withholding if you are a U.S.exempt partner in a partnership conducting a trade or business in the United
payee.If applicable,you are also certifying that as a U.S.person,your States,provide Form W-9 to the partnership to establish your U.S.
allocable share of any partnership income from a U.S.trade or business status and avoid withholding on your share of partnership income.
is not subject to the withholding tax on foreign partners'share of
effectively connected income.
Cat.No.10231X Form W-9(Rev.12-2011)
Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CARMEL, INDIANA
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
J. B. & M. J. M. of Indiana. Inc. Purchase Order No.
710 N. Plankinton Avenue, Suite 1200 Terms
Milwaukee, WI 53203 Date Due
Invoice Invoice Description
Date number or note attached invoices or bills Amount
DES#. 1297165 (Pennsylvania Street/ 111th Street
PARCEL: 63
J. B. & M.J. M. OF INDIANA INC.
BY: James Janz , President
$77,300.00
1 hereby certify that the attached invoice(s), or 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
,September 25 _, 20 12
ames J4 W, Pr ident
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
oros NF-/A
STATEMENT OF THE BASIS FOR JUST COMPENSATION(Cd0Q NF/A I
Irp
1. This is a written statement of, and summary of the basis for, the establishment of the amount believed to be, through a valuation
process,just compensation for the purchase of this right-of-way for highway purposes. The amount set forth in Item 5 below is not less
than the approved estimate of value. In accordance with Public Law 91-646 as amended, the "Uniform Act", and as codified in Indiana
at IC 8-23-17-1 through 8-23-17-35, this value disregards any decrease or increase in fair market value of the property prior to the date
of valuation caused by the public improvement for which the property is acquired other than physical deterioration within reasonable
control of the owner.
2. The legal description of this acquisition is set forth in the instrument of conveyance in the following identified parcel and
this acquisition is identified in the Acquiring Agency's records as:
Des.# 1297165 Parcel 63 Road Pennsylvania St. County Hamilton
Owner(s) J. B. & M.J. M.of Indiana, Inc.
3.The area and type of interest being acquired: 0.116 acres fee simple&0.155 acres temporary
The amount in Item 5 below includes payment for the purchase of all interests in the real property and no separately held
interest is being acquired separately in whole or part, except as may be explained in Item 8 below.
4.This acquisition is(Check one): a. ❑ A total acquisition of the real property.
b. ® A partial acquisition of the real property.
5. The Agency's Offer. Just compensation has been determined to be and the Acquiring Agency's offer for the purchase of
this real property is as follows:
a. Total Land, Land Improvements and Buildings $54,200
b. Severance Damages(i.e.: Setback, Loss in
Value to the Residues, etc)
c. Other Damages(Itemize)
Cost-To-Cure estimates:
Sprinkler System cost-to-cure $4,500
Temporary R/W $18,600
Total Damages $23,100
d. Perpetual Easement $0
Total amount believed to be Just Compensation offered for this Acquisition is: $77,300
6. The amount in Item 5 above may include payment for the purchase of certain buildings and improvements and their
ownership shall pass to the Acquiring Agency. These buildings and improvements are identified as follows:
None
7.The amount in Item 5 above may include payment for the purchase of certain Land Improvements, Fixtures, Equipment,
Machinery, Signs, Etc., and their ownership shall pass to the Acquiring Agency. These items are identified as follows:
Trees landscaping bushes,lawn
8. Items owned by others(i.e.: lessee, tenants, etc.) included in Item 5 above are identified as follows:
None
9. Remarks: none
City of Carmel Approval: ,�' Reviewer:
Signature: /� -- Signature:
Name Printed: Name Printed: Stephen A.Traynor
Title: Company: Traynor&Associates, Inc.
Date: ozl//2> Date: August 15, 2012
''
C (OMDY
4yi
CITYF EL
jA,v/irs BRAIN ARD, NLWOR
UNIFORM PROPERTY & EASEMENT ACQUISITION OFFER
J.P. & M. J.M. of Indiana, Inc. DATE: August 29, 2012
Mr. James F. Janz,President DES #: 1297165
710 N. Plankinton Avenue, Suite 1200 PARCEL: 63
Milwaukee,WI 5320? FS E SIMPLEPAR.TIAL: 0.116 Ac.
TEMPORARY EASEMENT: 0.155 Ac.
J.B. & M. J. M. of Indiana, Inc.
CT Corporation Syst°m, Registered Agent
251 E. Ohio Street, Suite 1100
Indianapolis, M 46204
The CITY OF CA.RMEL, INDIANA is authorized by Indiana law to obtain your land for certain
Public pu;pcses
The City of Cannel needs your property and an easement across your property for a public
improvement crntitled I I I"' Street and Pennsylvania Street(Des# 1297165) and needs to take the
land and easement as described on the attached land plat and legal descriptions.
See Exhibit A and Exhibit B
It is our opinion that the fair market value of the property and easement we want to acquire from
you is S7 1,300,00 and.therefore,we offer you $77,300.00 for the above-described property and
easement. You Have thirty (30) days from this date to accept or reject this offer. If you accept this
offer, you may expect payment in full within niriety (9M days after signing 11,.e documents acceptinb
this offer and executing the appropriate instruments, and provided there are no difficulties in
clearing liens or other problems with title to land. Posscssio;l wilt be required thirty (30) days after
you have received your payment in fit]1.
DEPARTwIENT of ENGINEERING
ONE OVIC S2aAhE, CANNIEL, IN 46032 OFFTrE 317571.2441 FA'\- 3"17.5712439
1=.,m"yIL enpneerin 9(carmcl.n . or
DES +: 1297165
PARCEL: 63
HERE IS A BRIE'SUMMARY OF YOUR OPTIONS AND LEGALLY LY PROTECTED RIGHTS:
1. Bylaw. the City of Carmel is required to make a good faith effort to purchase your property.
2. You do not have to accept this offer and the City of Carmel is not required to agree:to your
demands.
r
'f yC'll&,'1:)'..3CCept this of 'I', ,T:- -T%C :On;C to an a?r(:el:'.el}t O'.1`IhecC'J,111S1t10n Of
your property; the City of Carmel has the right to file suit to condemn and acquire the property and
basement i_7 0,i° county in which the real estate is located..
4. You have the right to seek advice of an attorney, real estate appraiser, or any other person of your
c}.,oic° (,n this matter.
5. Y�„ nip.- 1„,
et t.) the public purpos° and 11;oescihy of*his nrojec+.
6. ?f the City of Carmel files a suit to condemn and E.(ginn-your property, and the court grants its
request to condemn, the court will then appoint three appraisers who will make all independent
appraisal of the iroperty and easement to be acquired,
7. If we both agree with the court appraisers' report, then the platter is settled. However, if either of us
disagrees NN,;,.-h the aporaisers' report to the court, either of us has the right to ask for a trial to decide
what should.be paid to you for the propel-hy and easement condernned.
3. If t11P ^nt)rY artr,raic,E Y,�' report iS lar t c than ti�P i 'its n f 4 alr�Pl l ac +l P lacal
opticll ci t?, ;aositirlg the amount of the court antlraisPrs'evahlation with the court. And if
such a deposit is made with the court, the City of Carmel is legally entitled to inunediate
posse:,sicn of the property and easement. You may, subject to the approval of the court,
rr17?:e :.vitL:c? �.0 rls front the amount deposited Milt the court. Your N it1-,drawal "vill in i-o
w,a.y a: 0 ,t t'!i: ^�rCl;E,t:dlrt S Of yOLL'CaSP 111 cou,,t. e.-,,qx trial, If 11ri?1 judgrllellt awarded 1S
less than the withdrawal you have made from the amount deposited, you will be required to
a rin,.,..n.nt f tae na',pas back t- r o it t! e a 1 ou t of =.l _1 °s 4 O,
itlfit!?ment.
9. :lie rl'al `n%iil d.,c.ldc the full amount of damages you a-(' to r°(-.F-1ve. Roth of i,.s will be entitled to
T,re.ent .Cnai evidence supporting) our op!nions of?he value of the crop lly and easement. The
ne.nlorc or 1°ss t)"'i: C:Y?i. 9 Ou may°niulo %, at ynu,.- cost, aptr?,Isers and
-to r�,l,:-°S(:nr Von at this time or 9.t all) t'1_l'E' dur nQ t'le Coo,,,?-s° ^f the proCPe.ding described
?�: ill::, ;�;•;:e. • -
10. if;0u 111ve ifl.'V questions concernil a i 11S 'm itte , 1'0:1 may coIltact Assn'.-laced Right of Way
9ervi e, T 1 . a 6 '19 E. 10"' Street. Spite F-' TndiantipoliS. Tndialla. 6219, or to±=p}lode.
r"31 7) 2 C,??"
DES' 9: 1297165
PARCEL: 63)
This off-Cr wL.F madz I'o the owner; J. B. & NA. J. NIL u Indiana, Inc., in case of .fames F. Janz,
President, of lei i.v,,aukeo, Wisconsin, on the LI ciay of sep fembn- .2012.
This offer wLas made to tine owner, J. B. & M. J. "N/1. or Indiana, Inc.; In care of CT Corporation
System ?le is e, ea F� en , of!Marion County, Indiana, oil the y day or
2012.
BY
Lawrence Nit. Balla�wpe �
�.CClI,liSitli;l"i St!0C"tilllSt
Aonnt. Cit,, -tf+urine?. Ind`,ana t
Offer ma,'e by Certified Mail ���f y �-� 21 I
Offer made-loy Certified Mail iCDC, ( cow 0
COPY
DES 9: 1297165
PARCEL: 63
If you decide to acc�;�;t his offer of$77,300.00, sib l your name below and mail this form to the address indicated
above. An additional copy ofthis offer has been provided for your
ACCEPTANCE OF OFFER
We J. P,, 'rk � T. 1•!i. o India► ;, Inc._ ?andcI,vj.e°s of tII —x,(--d escribed �pre- qhar interest in
property,her:?�,✓ �:,rf-of 577300,00 made by 1-1ic C1.1-y o f t_.armel. Indiana on this day of
SP r1 Pmher _ , 2012.
J. B. & M. J. M. OF' INDIANA, INC.
BY:
James Janz, President
Printed Name and Tit 1 e
NOTARY'S CERTIFICATE
STATE OF WISCONSIN
)SS:
COUNTY OF WAUKESHA )
Subscribed and sworn to before me this 25 t h _ day of September _ , 2012.
My commission
County of residence: Waukesha _
Signature
s p�Y PU& Nirr,4! Be thN_ Zimmer ann
s i
BETH N. i
ZIMMERMANN
r
v-
1111111,gTF GO��
COPY
Des 4: 1297165
Parcel: 63
Partial Release of Assignment of Rents and Leases
This is to certify that a certain assignment of rents and leases executed by J.B. &M.J.M. of
Indiana, Inc. (Assignor)assign to Associated Bank,National Association (Assignee) dated April
15, 2004 and recorded June 17, 2004 as Instrument Number 200400042045 in the records of
Hamilton County, Indiana, is hereby released upon the following described real estate in
Hamilton County,Indiana:
See Attached Exhibit
Said Assignment of Rents and Leases remains in full force and effect as to the remainder of real
estate therein described.
The undersigned person executing this partial release of assignment of rents and leases represents
and certifies on behalf of Associated Bank,National Association(Assignee),that he/she is fully
empowered and authorized to execute this partial release of assignment of rents and leases on
behalf of Associated Bank,National Association (Assignee).
In witness whereof the said Assignee has caused this partial release of assignment of rents and
leases to be signed by its 3,��10 K F= and its seal
attached thereto this day of , 2012.
ASSOCIATED BANK,NATIONAL,ASSOCIATION
BY:
Ignature
Printed Name&Title
State of co N5 +►J )
SS:
County of L_VQ
Before me, the undersigned, a Notary Public in and for said County and State, personally
appeared 1'�"10 \k`z Q , Q "Cc 1�j
known to me to be the & ,y 0(k�es AD_y�- of the Assignee and
acknowledged the execution of the above partial release of assignment of rents and leases as and
for the act and deed of the said Assignee.
Witness my hand and notarial seal this �3 day of C 12012.
No ary ublic(Signat re) Notary Public(Printed)
` ',�5'.1;x 1➢^t Vii:t.�.
My Commission expires [aU I au 13 ;`�NcT,
My County of Residence is AAAJC
This Instrument Prepared By
<`.
I affirm, under the penalties for perjury, that I have taken reasonable care to redact each s6cial'security
number in this document, unless required by larv.
COPY
Des#: 1297165
Parcel: 63
Partial Release of Mortgage
This is to certify that a certain mortgage executed by J.B. & M.J.M. of Indiana, Inc. (Mortgagors)
to Associated Bank,National Association(Mortgagee), dated April 15, 2004, in the sum of
$6,724,904.00, and recorded June 17, 2004 as Instrument No. 200400042044 in the records of
Hamilton County, Indiana, is hereby released upon the following described real estate in
Hamilton County, Indiana:
See Attached Exhibit
Said Mortgage remains in full force and effect as to the remainder of real estate therein
described.
In witness whereof the said Associated Bank,National Association(Mortgagee) has caused this
partial release of mortgage to be signed by its r4 r&5-,0%v'i- and its seal
attached thereto this 0�3 day of 5 ifX 2012.
The undersigned person executing this partial mortgage release represents and certifies on behalf
of Associated Bank,National Association(Mortgagee), that he/she is fully empowered and
authorized to execute this partial mortgage release on behalf of Associated Bank, National
Association(Mortgagee).
ASSOCIATED BANK,NATIONAL ASSOCIATION
BY:
Signature
JOHN �o K4 i Tj 0-N
Printed Name and Title
State of \ScoNSiti )
SS:
County of
Before me, the undersigned, a Notary Public in and for said County and State, personally
appeared Q •
known to me to be the S r. of Associated Bank National Association,
(Mortgagee) and acknowledged the execution of the above partial release of mortgage as and for
the act and deed of the said Associated Bank,National Association(Mortgagee).
Witness my hand and notarial seal thisJ day of , 2012.
t-c.A-R, A.
No ary zblic (Signat re) Notary Public (Printed)
My Commission expires\- -w
My County of Residence isN_w,1 ���
This Instrument Prepared By
COPY
DES #: 1297165
PARCEL: 63
Cross Reference to Prior Deed of Record: Quitclaim Deed, Instrument Number 9709731965, in
the Office of the Recorder of Hamilton County, Indiana
TEMPORARY EASEMENT AGREEMENT
This Temporary Easement Agreement (this "Agreement") is made and entered into this
25th day of September , 2012 by and between J. B. & M. J. M. of Indiana, Inc., an
Indiana corporation, ("Grantor") and the City of Carmel, Indiana ("Grantee") for and in
consideration of the sum of Eighteen Thousand, Six Hundred Dollars ($18,600.00) (of which
said sum $18,600.00 represents land temporarily encumbered and improvements acquired and
$-0- represents damages).
RECITALS
A. Grantor owns certain real property (the "Grantor's Parcel") located in Hamilton County,
Indiana, more particularly described as follows:
See Exhibit 1 attached hereto and incorporated herein.
B. Grantee, in connection with Grantee's public improvement project entitled 111th Street
and Pennsylvania Street — DES #: 1297165 (the "Project"), requires a temporary easement for
the duration of the Project for purposes of constructing that portion of the Project located upon
and/or adjacent to the Grantor's Parcel. Such temporary easement area (herein referred to as the
"Temporary Easement Parcel") is more particularly described as follows:
See Exhibit A which is attached hereto and incorporated herein.
NOW, THEREFORE, in consideration of the foregoing recitals, all of which are
incorporated herein by this reference, and of the grant of easement and the mutual promises and
covenants set forth herein, the parties hereto agree as follows:
1. Temporary Rights quired by Grantee. During the term of the Project, Grantor
hereby grants and conveys to Grantee the exclusive right to utilize the Temporary Easement
Parcel for all purposes related to the construction of the Project, including, but not limited to, the
storing of equipment and the staging of the construction of the Project. Upon the earlier of the
date of final completion of the Project or three (3) years from the date hereof, such temporary
easement shall terminate and Grantee shall return the Temporary Easement Parcel to Grantor in
substantially the same condition as existed prior to the commencement of the Project, except as
reasonably modified by the Project.
832365v1
1
i
2. Rights Retained by Grantor. Grantor shall retain unto himself and his grantees,
heirs, successors and assigns, and all others to whom Grantor may grant rights or easements, the
right to use the Temporary Easement Parcel for any and all purposes and uses not inconsistent
with the foregoing easement acquisition by Grantee, including without limitation the right to
install, use, maintain, repair and replace existing driveways and curbing not removed by Grantee
as part of the Project; as well as the right of access over and across the Temporary Easement
Parcel to and from public streets adjacent to the Temporary Easement Parcel via Grantor's
existing driveway or any future driveway.
3. Easement and Covenants Appurtenant. The easement granted, created and made
herein, together with all the benefits thereof, shall run with the Grantor's Parcel and inure to the
benefit of Grantee and its (Yrantees, successors and assigns. The easement granted, created and
made herein, together with the burdens thereof, shall run with and bind the Grantor's Parcel, and
shall bind Grantor and his grantees, successors and assigns. All covenants and agreements of the
Grantor and Grantee hereunder, together with the benefits and burdens thereof, shall be deemed
to be real covenants which touch and concern the Grantor's Parcel and the Temporary Easement
Parcel, as applicable, shall run with the Grantor's Parcel and the Temporary Easement Parcel,
and shall inure to the benefit of and be binding upon Grantor and Grantee, as applicable, and
their respective grantees, successors and assigns.
4. Governing Law. This Agreement shall be governed by and construed in
accordance with the laws of the State of Indiana, except for its conflict of laws provisions.
The undersigned represents and warrants that Ile is a duly elected officer of the Grantor,
that the Grantor is a corporation validly existing in the State of its origin and, where required, in
the State where the subject real estate is situated; that the Grantor has full corporate capacity to
convey the real estate interest described; that pursuant to the resolution of the Board of Directors
or shareholders of the Grantor or the by-laws of the Grantor he has full authority to execute and
deliver this instrument on its behalf and that said authority has not be revoked; that he is
therefore, fully authorized and empowered to convey to the City of Carmel, hndiana real estate of
the Grantor, and that on the date of execution of said conveyance instruments Ile had full
authority to so act; and that all necessary corporate action for the making of this conveyance has
been duly taken.
IN WITNESS WHEREOF, Grantor and Grantee have executed this Anreement as of the
date first written above.
GRANTOR GRANTEE
J. B. & M. J. M. OF INDIANA, INC.
By: By:
Printed: James Janz Printed:
Title: President Title:
8 3236;1
STATE OF WISCONSIN )
) SS-.
COUNTY OF WAUKESHA )
Before me., a Notary Public in and for said County and State, personally appeared J. B. &
M. J. M. of Indiana, Inc., BY: James Janz , President
the
Grantor, and who, having been duly sworn, acknowledged the truth and accuracy of the
representations made herein and the execution of the foregoing Agreement.
Witness my hand and Notarial Seal this 25th day of September 2012.
M cone-nisslon s:
My �
Notary Public
I am a resident of Waukesha County
Beth N. Zimmermann
Printed Name
e �Itz
5F BETH N. y
i ZIMMERMANN
STATE OF INDIANA ) SS.
COUNTY OF HAMILTON ) �m��e`$
Before me, a Notary Public in and for said County and State, personally appeared
the
of the Grantee, who, having been duly sworn, acknowledged the truth and accuracy of the
representations made herein and the execution of the foregoing Agreement for and on behalf of
said Grantee.
Witness my hand and Notarial Seal this day of 2012.
My commission expires:
Notary Public
I am a resident of County, IN
Printed Name
This instrument was prepared by: Douglas C. Haney, Carmel City Attorney. One Civic Square,
Carmel, Indiana 46032
I affirm, under the penalties for perjury, that I have taken reasonable care to redact each and
every Social Security number in this document, unless it is required by law. Douglas C. Flaney
3323Givl
J
Exhibit 1
Pi rt of the West Half of the Northwest Qtaxtter of the South4.ast Quartcr of Section 2,Township
17 North, e 3 East of the Second Prin ' al Meridian in arnilton County,.� g 4p � ty, described
a4 follows: .
Z nni.ng at the northwcst corner of said bklf-quarter-quarter section;thence an an assumed
btaring of North 89 degrees 01 minutes 11 Seconds East along the north Iine thereof a distance of
6 5,83 feet to the northeast corner thereof; thence South 00 degrees 10 minutes 47 seconds East
along the east line of said half-quarter-quarter section a distance of 690.82 feet; thence South 89
dtgrz:s 01 minutes 11 seconds West paralldl with said north line a distance of 674.59 feet to the
west line of said half-quartcr-quarter section;thence North 010 degrees 16 minutes 59 seconds
West along said west Iine a distance of 690,,80 feet to the PIJINT OF BEGINNING
Qaataining 10.71 acres,more or less.
BEST P®SS BLE A GE
332365v1
4
Exhibit "A"
Sheet 1 of 1
Project: 1297165
Parcel: 63A Temporary Right-of-Way for Grading
Tax Id. No. 29-13-02-000-017.001-018
A part of the Southeast Quarter of Section 2, Township 17 North, Range 3 East, Hamilton
County, Indiana, described as follows: Commencing at the Northwest Corner of said southeast
quarter designated as point"1"on the Location Control Route Survey plat recorded as
Instrument 2010-015472, in the Office of the Recorder of said County; thence South 00 degrees
54 minutes 03 seconds West a distance of 203.48 feet, along the west line of said quarter; thence
South 89 degrees 05 minutes 58 seconds East a distance of 43.50 feet, to the eastern boundary of
Pennsylvania Street and the point of beginning of this description; thence South 89 degrees 05
minutes 58 seconds East a distance of 9.51 feet; thence South 00 degrees 54 minutes 02 seconds
West a distance of 175.00 feet; thence North 89 degrees 05 minutes 58 seconds West a distance
of 9.51 feet to the eastern boundary of Pennsylvania Street; thence North 00 degrees 54 minutes
03 seconds East a distance of 175.00 feet, along said eastern boundary, to the point of beginning
and containing 0.038 acres,more or less.
This description was prepared for the City of Carmel by Trent E. Newport, Indiana Registered
Land Surveyor, License Number 29600021, on the 1�fday of u F&1 4 , 2012.
���151£RF10 O�A
TRENT E. NEWPORT
INDIANA LAND SURVEYOR
No. 29600021 NO. LS 29600021
STATE OF
l AND I oA O�
9N� SUR`��y
Exhibit "A"
Sheet 1 of 1
Project: 1297165
Parcel: 63B Temporary Right-of-Way for Grading
Tax Id. No. 29-13-02-000-017.001-018
A part of the Southeast Quarter of Section 2, Township 17 North, Range 3 East, Hamilton
County, Indiana, described as follows: Commencing at the Northwest Confer of said southeast
quarter designated as point"1" on the Location Control Route Survey plat recorded as
Instrument 2010-015472, in the Office of the Recorder of said County; thence South 89 degrees
50 minutes 16 seconds East a distance of 165.00 feet, along the north line of said quarter; thence
South 00 degrees 09 minutes 44 seconds West a distance of 40.00 feet, to the southern boundary
of 111 uh Street and the point of beginning of this description; thence South 89 degrees 50 minutes
16 seconds East a distance of 215.00 feet, along said southern boundary; thence South 00
degrees 09 minutes 44 seconds West a distance of 22.00 feet; thence North 89 degrees 50
minutes 16 seconds West a distance of 250.00 feet; thence North 58 degrees 00 minutes 36
seconds East a distance of 41.34 feet, to the point of beginning and containing 0.117 acres,more
or less.
This description was prepared for the City of Carmel by Trent E. Newport, Indiana Registered
Land Surveyor, License Number 29600021, on the,_r day of�, 2012.
N£�'0
���ISTfRF� O.pf
TRENT E. NEWPORT
INDIANA LAND SURVEYOR
No. 29600021 NO. LS 29600021
STATE OF
l ND I ANP O�
9N�
COPY
DES 4: 1297165
PARCEL: 63
WARRANTY DEED
THIS INDENTURE WITNESSETH THAT J. B. & M. J. M. of Indiana, Inc., an
Indiana corporation ("Grantor"), conveys and warrants to the City of Carmel, Indiana
("Grantee"), for the sum of Fifty-eight Thousand, Seven Hundred and 00/100 Dollars
($58,700.00) ) (of which $54,200.00 is paid for land and improvements and $4,500.00 is paid as
damages) and other valuable consideration, the receipt and sufficiency of which is hereby
acknowledged, the following described real estate in Hamilton County, State of Indiana:
See attached Exhibit A and Exhibit B, which are attached hereto and incorporated herein
Subject to any and all easements, agreements, restrictions and other matters of record.
It is understood between the parties hereto, and their successors in title, and made a
covenant herein which shall run with the land, that all real estate herein described (excepting any
parcels or portions thereof that are specifically and expressly designated as easements or
temporary rights of way) are conveyed in fee simple and not merely for right of way purposes,
and that no reversionary rights whatsoever are intended to remain in the Grantor.
The Grantor assumes and agrees to pay the 2011 real estate taxes and assessments
payable in 2012 and the 2012 real estate taxes and assessments payable in 2013, and any and all
delinquent real estate taxes, interest and penalties on the above described real estate. This
obligation to pay shall survive the said closing and shall be enforceable by the Grantee in the
event of non-payment.
The undersigned represents and warrants that he is a duly elected officer of the Grantor;
that the Grantor is a corporation validly existing in the State of its origin and, where required, in
the State where the subject real estate is situated; that the Grantor has full corporate capacity to
convey the real estate interest described; that pursuant to the resolution of the Board of Directors
or shareholders of the Grantor or the by-laws of the Grantor he has full authority to execute and
deliver this instrument on its behalf and that said authority has not be revoked; that he is
therefore, fully authorized and empowered to convey to the City of Carmel, Indiana real estate of
the Grantor, and that on the date of execution of said conveyance instruments he had full
authority to so act; and that all necessary corporate action for the making of this conveyance has
been duly taken.
DES #: 129716
PARCEL: 63
I_N WITNESS WHEREOF, Grantor has caused this Warranty Deed to be executed this
_ 25th day of September . 2012.
GRANTOR:
J. B. & M. J. M. OF INDIANA, INC.
i
BY:
Janes Janz ,—President
Prirtei lane -and Tidz
NOTARY CERTIFICATION
STATE OF WISCONSIN )
) SS:
COUNTY OF WAUKESHA )
Before l e YP 7'1 fi,�r i(7 n d a Notary Public i� in and or said County and State, ppersonally b
appeared J. B. & M. J. M. of Indiana. Inc„ BY: James Janz , President
who
acknowledged the execution of the foregoing Warranty Deed for and on behalf of such Grantor,
and who, iia-,ing been duly sworn, stated that the representations therein contained are true.
WIT?'dE SS lny hand and Notarial Seai t1-i, 25 y of_ e er _ ' 2012.
My Commission£� ifes: ► S
County of Waukesha_ ---- -- — — -- -- - --
\\\\\\\\\\\j'�► Notar QiQllatl_IP --
Beth N . Zimmermann
gam{N. Notary (Printed Name)
`o ° ZIMMERMANN
831464v;
2
DES T: 1297165
PARCEL: 63
This instrument was prepared by Douglas C. Haney, Carmel City Attorney, City Hall, One Civic Square,
Carmel, Indiana 46032
Send tax bills to: One Civic Square, Carmel, IN 46032
After recording, return Deed to Douglas C. Haney, Carmel City Attorney, City Hall, One Civic Square,
Carmel, Indiana 46032
I cgyii'ii?, unciei"ilfE�Jei'rLitiiC'J�O]'�EZJZl3�%, ihatl hai)e take)) )'eYiso.riab/e care to redact Each ai0 eveiD,
Social Secau'ity l7ii7iiber.fi-oin this document, unless it is i°equired by law. Douglas C. Haney
831464vl
Exhibit "A"
Sheet 1 of 2
Project: 1297165
Parcel: 63 Pee
Tax Id. No. 29-13-02-000-017.001-018
A part of the Southeast Quarter of Section 2, Township 17 North, Range 3 East,Hamilton
County, Indiana, and being that part of the grantor's land lying within the right of way lines
depicted on the attached Right of Way Parcel Plat, marked Exhibit`B", described as follows:
Commencing at the Northwest Corner of said southeast quarter designated as point"1"on the
Location Control Route Survey plat recorded as Instrument 2010-015472, in the Office of the
Recorder of said County; thence South 89 degrees 50 minutes 16 seconds East a distance of
165.00 feet, along the north line of said quarter; thence South 00 degrees 09 minutes 44 seconds
West a distance of 40.00 feet, to the southern boundary of 11 lch Street and the point designated
"320"on said Parcel Plat being the point of beginning of this description; thence South 58
degrees 00 minutes 36 seconds West a distance of 41.34 feet to the point designated "319" on
said Parcel Plat; thence North 89 degrees 50 minutes 16 seconds West a distance of 15.00 feet to
the point designated"305" on said Parcel Plat; thence South 78 degrees 51 minutes 08 seconds
West a distance of 15.30 feet to the point designated"304" on said Parcel Plat; thence South 44
degrees 37 minutes 17 seconds West a distance of 61.95 feet to the point designated"303" on
said Parcel Plat; thence South 12 degrees 12 minutes 38 seconds West a distance of 25.50 feet to
the point designated "302" on said Parcel Plat; thence South 00 degrees 54 minutes 02 seconds
West a distance of 70.00 feet to the point designated"322"on said Parcel Plat; thence North 89
degrees 05 minutes 58 seconds West a distance of 9.51 feet to the eastern boundary of
Pennsylvania Street and the point designated"323"on said Parcel Plat; thence North 00 degrees
54 minutes 0') seconds East a distance of 164.04 feet, along said eastern boundary of
Pennsylvania Street, to the southern boundary of 111 ch Street; thence South 89 degrees 50
Exhibit "A"
Sheet 2 of 2
Project: 1297165
Parcel: 63 Fee
Tax Id. No. 29-13-02-000-017.001-018
minutes 16 seconds East a distance of 122.01 feet, along said southern boundary, to the point of
beginning and containing 0.116 acres, more or less.
This description was prepared for the City of Carmel by Trent E. Newport, Indiana Registered
Land Surveyor, License Number 29600021, on the D day-of kvs/1 !.{ , 2012.
N
E f
S T'REO 4 A
TRENT E. NEWPORT
INDIANA LAND SURVEYOR
No. 29600021 NO. LS 29600021
STATE OF
�11D I
qNa S
Exhibit "B Sheet 1 of 2
Right—of—Way Parcel Plat
Prepared for City of Carmel
By CrossRood Engineers, P.C.
16+00 17+00 18+00 19+00 20+00
7
1
111th. Street
LINE "B" 2 1
675.83'
o I $I
3 Sell—Off
� �-- -------r---------------------- -------`675.76'-------------- -------------------------------- •a 2 1
; ' 15.OD °i
O I I
I �I
O R
} i i 2 20' esmt for gas
28.50 i s�� 0 19 line in favor of 5501
ti Indiana Gas
Company, Inc.
ii 0
O in
O
D
ii 10' Esmt for landscaping in favor
of the City of Carmel, Indiana
I II 2
I II
O i ii 20' esmt for sewer line in
O ¢ --favor of Clay Township
wRegional Waste District
n-
rn '
O ° i li rn
J I II to
i' I II
Sell—Off
I a
I u
2 0' 120' 240'
O I
O
+ i Scale: 1"= 120'
CIS
q i of—Off
tt1 �
I
q
I
a� I
I
28.50"
I
15.00'
r --I
674.59'
I�I 15' Esmt for storm sewer in
favor of Charter Arbor Indy
2 Behavioral Health Systems, LLC.
11 1 5502
Parcel: 63 Owner: J.B. & M.J.M. OF INDIANA, INC. Drawn By: J.WHITESIDE Date: 0810812012
Code: Checked By: R.PERRY Date: 0810812012
Project: 1297165 DES. No. 1297165
Road: 111th. ST& PENNSYLVAN14 ST. INST. 9709731965 DATE: 08 05 1997
County. HAMILTON Hatched Area is the INST. 9008599 DATE.-O4 18 1990
Section 2 Approximate Taking INST. 9008700 DATE. 04/18 1990
Township: 17N INST 9427142 DATE: 06/1 /1994
Range: 3E INST 200300062249 DATE.' 06 27/2003
Note: Centerline Stationing is English F —
11 19 Sheet 2 of 2
Exhibit
Right—of—Tay Parcel Plat
Prepared for City of Carmel
By CrossRood Engineers, P.C.
Parcel Coordinate Chart (Shown in Feet)
Point Centerline Station Offset Northing Eastin
1
2
3
7 See Location Control Route Survey Plat
5501
5502
302 A" 146+45.00 65.00' R 9185.9128 5126.5264
303 A 146+70.00 70.00' R 9210.8311 5131.9187
322 A' 145+75.00 65.00' R 9115.9214 5125.4262
323 A" 145+75.00 PL 55.49' R 9116.0709 5115.9157
304 13" 16+00.00 65.00' R 9254.9270 5175.4357
305 6" 16+15.00 62.00' R 9257.8845 5190.4441
319 8" 16+30.00 1 62.00' R 1 9257.8421 5205.4440
320 1 9" L 16+65.00 1 PL 40.00' R 1 9279.7428 5240.5062
Note: Stations & Offsets control over both North & East Coordinates and Bearings
& Distances.
To the best of my knowledge and belief, this plat, together with the "Location Control Route �� . NE�l,A
Survey' recorded as Instrument Number 2010-015472 in the Office of the Recorder of Hamilton ISTE Q
County, Indiana, (Incorporated and mode a part hereof by reference) comprise a Route Survey �� � RFa
executed in accordance with Title 865 Indiana Administrative Code 1-12, (Rule 12). No. LS
�YV / /� �L 29600021
y l f � STATE OF
Trent E. Newport Date 9 7Np1ANA
Reg. Land Surveyor No. 29600021 y
State of Indiana ti4) S U R v Development Consultants
X7 9EW lal
azn c )v 451W 451W 7M
Parcel: 63 Owner: J.B. & M.J.M. OF INDIANA, INC. Drawn By: J.WHITESIDE Date: 0810812012
Code: Checked By: R.PERRY Date: 0810812012
Project: 1297165 DES. No. 1297165
Road: 111th. ST& PENNSYLVANIA ST. INST. 9709731965 DATE: 0810511997
County: HAMILTON Hatched Area is the INST. } 9008699 DATE04 1811990
Section 2 Approximate Taking INST. } 9008700 DATE: 041181.1990
Township: 17N INS T. 9427142 DATE: 0611511994
Range: 3E Note: Centerline Stationing is English INST 200300062249 DATE' 06 2711003
CLOSING STATEMENT
Section 6045 of the Internal Revenue Code, as amended by the Tax Reform Act of 1986,
requires the reporting of certain information on every real estate transaction. The information
provided below, except for the tax identification number, is adequate information to provide to a
tax professional.
FEE OWNER: J.B. & M.J.M. of Indiana, Inc.
MAILING ADDRESS: 710 N. Plankinton Avenue, Suite 1200, Milwaukee, W153203
PROPERTY ADDRESS: 11075 N. Pennsylvania St., Indianapolis, IN 46280
DESCRIPTION OF PROPERTY: A part of the Southeast Quarter of Section 2, Township 17
North, Range 3 East, Hamilton County, Indiana
TAX PARCEL ID: 29-13-02-000-017.001-018
PROJECT: Des No. 1297165, 111`h St. and Penn St., City of Carmel,
PROJECT PARCEL. 63 COUNTY. Hamilton
CLOSING DATE: PURCHASE PRICE: $ 77,300.00
LAND AND/OR ADMINISTRATIVE SETTLEMENT. $ 0.00
IMPROVEMENTS: $54,200.00 DAMAGES: $ 23,100.00
Please be advised that no property taxes have been assumed by the City of Carmel in
connection with the purchase of the above-captioned property. Any applicable tax adjustment,
due to the above purchase by the City of Carmel, would be accomplished by the County
Assessor after the deed is recorded by the City or its agent. This is supposed to be done;
however, you should take the initiative to make this adjustment. The City of Carmel has no
authority to remove or change any taxes of any nature.
I (we) certify that the above is true and correct and acknowledge receipt of payment.
Fee Owners
Signature Date
Signature Date
DES #: 1297165
PARCEL: 63
Cross Reference to Prior Deed of Record: Quitclaim Deed, Instrument Number 9709731965, in
the Office of the Recorder of Hamilton County, Indiana
TEMPORARY EASEMENT AGREEMENT
This Temporary Easement Agreement (this "Agreement") is made and entered into this
25th day of September , 2012 by and between J. B. & M. J. M. of Indiana, Inc., an
Indiana corporation, ("Grantor") and the City of Carmel, Indiana ("Grantee") for and in
consideration of the sum of Eighteen Thousand, Six Hundred Dollars ($18,600.00) (of which
said sum $18,600.00 represents land temporarily encumbered and improvements acquired and
$-0-represents damages).
RECITALS
A. Grantor owns certain real property (the "Grantor's Parcel") located in Hamilton County,
Indiana, more particularly described as follows:
See Exhibit 1 attached hereto and incorporated herein.
B. Grantee, in connection with Grantee's public improvement project entitled 111th Street
and Pennsylvania Street — DES #: 1297165 (the "Project"), requires a temporary easement for
the duration of the Project for purposes of constructing that portion of the Project located upon
and/or adjacent to the Grantor's Parcel. Such temporary easement area (herein referred to as the
"Temporary Easement Parcel") is more particularly described as follows:
See Exhibit A which is attached hereto and incorporated herein.
NOW, THEREFORE, in consideration of the foregoing recitals, all of which are
incorporated herein by this reference, and of the grant of easement and the mutual promises and
covenants set forth herein, the parties hereto agree as follows:
1. Temporary Rights Acquired by Grantee. During the term of the Project, Grantor
hereby grants and conveys to Grantee the exclusive right to utilize the Temporary Easement
Parcel for all purposes related to the construction of the Project, including, but not limited to, the
storing of equipment and the staging of the construction of the Project. Upon the earlier of the
date of final completion of the Project or three (3) years from the date hereof, such temporary
easement shall terminate and Grantee shall return the Temporary Easement Parcel to Grantor in
substantially the same condition as existed prior to the commencement of the Project, except as
reasonably modified by the Project.
8323650
I
2. Rights Retained by Grantor. Grantor shall retain unto himself, and his grantees,
heirs, successors and assigns, and all others to whom Grantor may grant rights or easements, the
right to use the Temporary Easement Parcel for any and all purposes and uses not inconsistent
with the foregoing easement acquisition by Grantee, including without limitation the right to
install, use, maintain, repair and replace existing driveways and curbing not removed by Grantee
as part of the Project, as well as the right of access over and across the Temporary Easement
Parcel to and from public streets adjacent to the Temporary Easement Parcel via Grantor's
existing driveway or any future driveway.
3. Easement and Covenants Appurtenant. The easement granted, created and made
herein, together with all the benefits thereof, shall run with the Grantor's Parcel and inure to the
benefit of Grantee and its grantees, successors and assigns. The easement granted, created and
made herein, together with the burdens thereof, shall run with and bind the Grantor's Parcel, and
shall bind Grantor and his grantees, successors and assigns. All covenants and agreements of the
Grantor and Grantee hereunder, together with the benefits and burdens thereof, shall be deemed
to be real covenants which touch and concern the Grantor's Parcel and the Temporary Easement
Parcel, as applicable, shall run with the Grantor's Parcel and the Temporary Easement Parcel,
and shall inure to the benefit of and be binding upon Grantor and Grantee, as applicable, and
their respective grantees, successors and assigns.
4. Governing Law. This Agreement shall be governed by and construed in
accordance with the laws of the State of Indiana, except for its conflict of laws provisions.
The undersigned represents and warrants that he is a duly elected officer of the Grantor;
that the Grantor is a corporation validly existing in the State of its origin and, where required, in
the State where the subject real estate is situated; that the Grantor has full corporate capacity to
convey the real estate interest described; that pursuant to the resolution of the Board of Directors
or shareholders of the Grantor or the by-laws of the Grantor he has full authority to execute and
deliver this instrument on its behalf and that said authority has not be revoked; that he is
therefore, fully authorized and empowered to convey to the City of Carmel, Indiana real estate of
the Grantor, and that on the date of execution of said conveyance instruments he had full
authority to so act; and that all necessary corporate action for the making of this conveyance has
been duly taken.
IN WITNESS WHEREOF, Grantor and Grantee have executed this Agreement as of the
date first written above.
GRANTOR GRANTEE
J. B. & M. J. M. OF INDIANA, INC.
By: By:
Printed: James J anz Printed: ty ,
Title: President Title:
832365v1
s •
STATE OF WISCONSIN )
SS:
COUNTY OF WAUKESHA )
Before me, a Notary Public in and for said County and State, personally appeared J. B. &
M. J. M. of Indiana, Inc., BY: James Janz , President
the
Grantor, and who, having been duly sworn, acknowledged the truth and accuracy of the
representations made herein and the execution of the foregoing Agreement.
Witness my hand and Notarial Seal this 25th day of September , 2012.
My commission des:
Notary Public
1 am a resident of Waukesha County
Beth N. Zimmermann
Printed Name ���P
BETH N. c 4
ZIMMERMANN
STATE OF INDIANA j SS.
COUNTY OF HAMILTON ) �01��,OF�W`�
B ore me a Notary Public in and for said County and State, persona ap eared
S . , E '
, the
of the Grantee, who, having beV duly sworn, acknowledged the tr th and accuracy of the
representations made herein and the execution of the foregoing Agreement for and on behalf of
said Grantee.
Witness my hand and Notarial Seal this tl lay of 201T �
My commission expires: 3 Jp&
1, Notary Public
r;J am a;:resident-of County, IN
�•�� PrinteName
This instrument was prepared by: Douglas C. Haney, Carmel City Attorney, One Civic Square,
Carmel, Indiana 46032
I affirm, under the penalties for perjury, that I have taken reasonable care to redact each and
every Social Security number in this document, unless it is required by law. Douglas C. Haney
8323650
J
Exhibit 1
Phrt of the West Half of the Northwest Qugtter_of the South4ast Quarter of Section 2,Township
17 North,Range 3 East of the Second Principal Meridian in)ffamilton County,Indiana,described
r.,
a4 follows:
BK&ning at the northwest corner of said half-quarter-quarter section;thence on an assumed
btuing of North 89 degrees 01 minutes 11 seconds East along the north line thereof a distance of
r'
05,83 feet to the northeast corner thereof;thence South 00 degrees 10 minutes 47 seconds East
along the east line of said half-quarter-quart-er section a distaince of 690,82 feet; thence South 89
degrees 01 minutes 11 seconds West paralldl with said north line a distance of 674.59 feet to the
west line of said half-quarter-quarter sectio a;thence North 010 degrees 16 minutes 59 seconds
West along said west line a distance of 690A0 feet to the PINT OF BEGINNING.
CQontaining 10.71 acres,more or less,
13EST P®SS LE JADE
832365v1
4
Exhibit "A"
Sheet 1 of 1
— - -- --Project.-1297-165- —- --- -- -- - —- - -— — -- — - - - —
Parcel: 63A Temporary Right-of-Way for Grading
Tax Id. No. 29-13-02-000-017.001-018
A part of the Southeast Quarter of Section 2, Township 17 North, Range 3 East,Hamilton
County, Indiana, described as follows: Commencing at the Northwest Corner of said southeast
quarter designated as point"1"on the Location Control Route Survey plat recorded as
Instrument 2010-015472, in the Office of the Recorder of said County; thence South 00 degrees
54 minutes 03 seconds West a distance of 203.48 feet, along the west line of said quarter; thence
South 89 degrees 05 minutes 58 seconds East a distance of 43.50 feet, to the eastern boundary of
Pennsylvania Street and the point of beginning of this description; thence South 89 degrees 05
minutes 58 seconds East a distance of 9.51 feet; thence South 00 degrees 54 minutes 02 seconds
West a distance of 175.00 feet; thence North 89 degrees 05 minutes 58 seconds West a distance
of 9.51 feet to the eastern boundary of Pennsylvania Street; thence North 00 degrees 54 minutes
03 seconds East a distance of 175.00 feet, along said eastern boundary, to the point of beginning
and containing 0.038 acres, more or less.
This description was prepared for the City of Carmel by Trent E. Newport, Indiana Registered
Land Surveyor, License Number 29600021,on the S day of u f , 2012.
E. N �(I V
A,�� � a
TRENT E. NEWPORT
INDIANA LAND SURVEYOR
No. 29600021 NO. LS 29600021
STATE Of
l AND I
qNa SUR���
Exhibit "A"
Sheet 1 of 1
Project: 1297165
Parcel: 63B Temporary Right-of-Way for Grading
Tax Id. No. 29-13-02-000-017.001-018
A part of the Southeast Quarter of Section 2,Township 17 North, Range 3 East, Hamilton
County, Indiana, described as follows: Commencing at the Northwest Corner of said southeast
quarter designated as point"1"on the Location Control Route Survey plat recorded as
Instrument 2010-015472, in the Office of the Recorder of said County; thence South 89 degrees
50 minutes 16 seconds East a distance of 165.00 feet, along the north line of said quarter;thence
South 00 degrees 09 minutes 44 seconds West a distance of 40.00 feet, to the southern boundary
of 111'h Street and the point of beginning of this description; thence South 89 degrees 50 minutes
16 seconds East a distance of 215.00 feet, along said southern boundary; thence South 00
degrees 09 minutes 44 seconds West a distance of 22.00 feet; thence North 89 degrees 50
minutes 16 seconds West a distance of 250.00 feet; thence North 58 degrees 00 minutes 36
seconds East a distance of 41.34 feet, to the point of beginning and containing 0.117 acres,more
or less.
This description was prepared for the City of Carmel by Trent E. Newport, Indiana Registered
Land Surveyor, License Number 29600021, on the rday of�, 2012.
E. N ^Y 1/
�A0
TRENT E. NEWPORT
INDIANA LAND SURVEYOR
No. 29600021 NO. LS 29600021
STATE OF
l AND i ANA p�'
qND SURvO
r SALES DISCLOSURE FORM
State Form 46021(R11/12-11) SDF ID
t
Prescribed by Department of Local Government Finance County Year Unique ID
Pursuant to IC 6-L1-5.5
SDF Date:
PRIVACY NOTICE:The telephone numbers and Social Security numbers of the parties on this form are confidential
according to IC 6-LS-SS-3 d
' t
S.Property Number Check box if applicable to S.Complete Address of Property 6.Complete Tax Billing Address(if differentfrom
parcel /\ ` ` property address)
F 0 2.Split U S M 61(a luanir� ONE CIIC SQUARE
DZ ow-D i�1 ODI- [� 3.Land li16AXkc10oVs l )K1 "liT9D CARMEL, IN 46032
❑ 4.Improvement
7.Legal Description of Parcel A:
C lac
B.) ® 2.Split
® 3.Land
❑ 4.Improvement
7.Legal Description of Parcel B:
":B�(II�IU1:tiI;UI�" 'Illx SI. -i�1•L��' _ I?< _ �a-� =;�`,. _ -ajfs �. r': _ _� i.,. ...
�o•; °-�4--`�, �;E.. -,---,��-_ ...4; _ .r~a+,s,-,.,''.. .�.€.t�, -.M��_' �. �,.=-`„=.�c'�r;:mss,.�°
-..yr. __:°L{=Jf _m1'. .�'w-- "4:^ _ _- �'�-' - s-re.`.-i."_. ��. n�y_ _ of 4-�--..may-:c'�.'n,� L.I�:'•ir�-',.'v'y!m yn._-'Y'tF-x
��.._ .,:..t. A 5'+e:'_ -•ztiy��"A!. ,} ttt±��..j 'f-� y
�r:a..?:li}�_'r.�."d:''a:'i+=.:.:y`_1_.:_"r.�,.Y_.: %viri;'u`>-ri.-:.-'2�."ie��'«i'dl...'a .X.'�- =,t4rE.r ?.. ..:.4'i•1�1r1��S�"�.ili_ii:��::_,;c-.. __ _i'rsY��k-.._C'}.:-rev :::�-���.v4'===°s'r=?*�._-'s}t`.:C wS-y::S'2M.:�1
If condition 1 applies,Filer is subject to disclosure and a disclosure filing feu
1.Conveyance date of./.DI...: ni lJ 1
YES NO CONDITION
❑ 1.A transfer of real property interest for valuable 2.Total number of parcels:
consideration. 3.Describe any unusual or special circumstances related to this
❑ �) 2.Buyer is an adjacent property owner. sale,including the specification of any less-than-complete"
`99 ❑ 3.Vacant land, ownership interest and terms of seller financing.
❑ 4.Exchange for other real property("Trade"). 136: Right-of-Way Acquisition for Highway
❑ S.Seller paid points.Provide thevalueTableCltemu) Purposes.
UTj ❑ 6.Change planned in the primary use of the
property?(Describe in special circumstances in Table C Item 3•)
❑ 19; 7.Existence of family or business relationship 2
between buyer and seller.(Complete Table Citem4.) DAMAGES.
❑ 0 8.Land contract Contract term(Yr):
and contract date(mmlaD/YYYr):
❑ 9.Personal property included in transfer.(Providethevalue YES NO CONDITION
TobleCltem S.)
E] 10.Physical changes to property between March 1 E] 4.Family d business relationship existing between
and date of sale.(Describe in special circumstances inTableeltem3.) buyer and seller?
Amount of discount: $
❑ 11.Partial interest(Describe in special circumstances in Table C Item 3.)
Disclose actual value in money,property,a service,an agreement or other consideration.
❑
12.Easements or right-of-way grants.
If conditions 13-15 apply,Filers are subject to disclosure,but no disclosure filing fee. S.Estimated value of personal property: $ I A
YES NO CONDITION 6.Sales rice:
❑ 13.Document for compulsory transactions as a YES NO CONDITION
7� result of foreclosure or express threat of ❑ 7•is the seller financing sale? If yes,answer
foreclosure,divorce,court order,judgment, questions(8-13).
condemnation,or probate.
E] ✓ 14.Documents involving the partition of land ❑ 8.Is buyer borrower personally liable for loan?
between tenants in common,joint tenants,or ❑ 9.Is this a mortgage loan?
tenants by the entirety. 10.Amount of loan: $ NA
t ❑ 15.Transfer to a charity,not-for-profit organization, 11.Interest rate: NA oho
or government
12.Amount in points: $ NA
13.Amortization period: NA
INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
Lnr irL Inn o e LAND AGENT
Preparer ofthe Sales isclosureForm Title
6919 E. 10th STREET, SUITE E-2 AR_OWS, INC.
Address(Number and Street) Company
INDIANAPOLIS, IN 46219 (317)322 70489 lballantyne @arows.biz
City,State,and ZIP Code Telephone Number E-mail
o IN►�i )R 100
Seller 1.Name as appears on conveyance document Seller2-Name as appears on conveyance document
710 N. Plankinton Ave Ste 1 00
Address(Number and Street) Address(Number and Street)
Milwaukee , WI 53201
City,State,and ZIP Code City;State,and ZIP Code
( 414 )-.274-2413 james _jan7.@7. c m
Telephone Number E-mail Telephone Number
E-mail
Under penalties of perjury,I hereby certify that this Sates Disclosure,to the best of my knowledge and belief,is true,correct
and complete as require by law,and is prepared in accordance with IC 6-1.1-5.5,"heal Property Sales Disclosure Act".
S1910-eofSeller 6 Signature of Seller
James Janz, Presi deny A / 2 1� z
Printed Name o Seller Sian Date(MM/DD/YM Printed Name o Seller Sign Dare(MM/DD
Ep`'�° ;�-- -- - - -;;•. - - - _ - - _ = _ -- - - - .....max - -
~4
E -� ���A:I�Pf��.T:t• -R�' R=�
m.
:1' _ .�: - A��E1)� �:I�IS��BE�TTT-i=FY�.�.L�i,`�M
v
;r
u
CITY OF CARMFLl_IND_IANA
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
ONE CIVIC SQUARE
Address(Number and Street) Address(Number and Street)
CARMEL, IN 46032
City,State,and ZIP Code City,State,and ZIP Code
(317) '571-2441
Telephone Number E-mailr Telephone Number
E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
❑ 1.Will this property be the buyer's primary ❑ M 3.Homestead
residence? Provide complete address of primary ❑ M 4.Solar Energy Heating/Cooling System
racirlence.incliMinucnonty- ❑
ONE CIVIC SQUARE E S.Wind Power Device
,,,,a-,....M•..^tio.^ 1 _O ❑ M 6.Hydroelectric Power Device
CARMEL, IN 46032 NAMTT TC)1 ❑ M 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ M 2.Does the buyer have a homestead in Indiana to be E:1 ® 8•Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ M 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
City,State ZIP Code County
Primary property owner contact name E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".(Note:
Spouse information,Social Security and Driver's License/Other numbers are not necessary if no homestead Deduction is
being filed.)
Signature ofBuyerl r� Signature ofBuyer2/Spouse
Printed Legal Name of Buyer 1 Sign Date(MM/DD/Y)n Printed Legal Name ofBuyer2/Spouse Sign Date(MM/DD/)'1 M
Last 5 digits ofBuyer 1 Driver's State Last 5 Digits ofSocial Security Number Last 5 digits ofBtyer2/Spouse Driver's State Lost 5 Digits ofSocial Security
License/ID10therNumber Number License/ID/Other Number
INDIANA SALES DISCLOSURE FORM SDF ID: page 3
The county assessor must verify and complete items 1 through 14 and stamp the sales disclosure form before sending to the auditor:
1.Property 2.AVLand 3,AV Improvement 4.Value ojPersonal S.AV Total 6.Property 7.Neighborhood B.Tax District 9.Acreage
Property Class Code Code
A,)
E.)
Assessor Stamp 10.Identify physical changes to property between March 1 and YES No CONDITION
date of sale. ❑ ❑ 11.Is form completed?
❑ ❑ 12.State sales fee required?
13.Date of sale jmm1DD1MrMr):
14.Date form received(MM/DD/YYnj:
Items•1 xhr S
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Auditor Stamp
1.Disclosure fee amount collected:$ YES NO CONDITION
2.Other Local Fee: $ ❑ ❑ 6.Is form completed?
3.Total Fee Collected:$ ❑ ❑ 7,Is state fee collected?
4^Auditor receipt book number: ❑ ❑ S.Attachments complete?
S.Date of transfer Cmmlm/MMMt):
------------------------------------------ --------------------
! 4 - ]�^�E---..c,�h. vcm L .F sL:-•, 'u'^'c, F� _
"W ,�sppa' `' 'mt.
JEW YS eTYetl:e'.='�•t+r,� ...bt .�2 d.,. �_.,•S M^SI{.'
SDFID SDFDate(MM/DD/Mn`s')_ Buyerl-Nameasappearsonconveyancedocument
Parcel Number Address ofPropert}+(Number and Street)
Check all that apply:
City,Staigand ZIPCodeojProperty
❑ Homestead ❑Solar Energy F-1 Wind Power
❑ Hydroelectric ❑Geothermal ❑ Rental Property Auditor Signature Dow(MM/DD/n'YM)
Electronic Statement e-mail
A person who knowingly and intentionally falsifies value of transferred real property,or omits or falsifies any information required to be provided in
the sales disclosure form commits a Class C felony.
Exhibit "A"
Sheet 1 of 2
Project: 1297165
Parcel: 63 Fee
Tax Id. No. 29-13-02-000-017.001-018
A part of the Southeast Quarter of Section 2, Township 17 North, Range 3 East, Hamilton
County, Indiana, and being that part of the grantor's land lying within the right of way lines
depicted on the attached Right of Way Parcel Plat, marked Exhibit`B", described as follows:
Commencing at the Northwest Corner of said southeast quarter designated as point"1"on the
Location Control Route Survey plat recorded as Instrument 2010-015472, in the Office of the
Recorder of said County; thence South 89 degrees 50 minutes 16 seconds East a distance of
165.00 feet, along the north line of said quarter; thence South 00 degrees 09 minutes 44 seconds
West a distance of 40.00 feet, to the southern boundary of 111`h Street and the point designated
"320"on said Parcel Plat being the point of beginning of this description; thence South 58
degrees 00 minutes 36 seconds West a distance of 41.34 feet to the point designated "319"on
said Parcel Plat; thence North 89 degrees 50 minutes 16 seconds West a distance of 15.00 feet to
the point designated"305"on said Parcel Plat; thence South 78 degrees 51 minutes 08 seconds
West a distance of 15.30 feet to the point designated`.`304"on said Parcel Plat; thence South 44
degrees 37 minutes 17 seconds West a distance of 61.95 feet to the point designated"303"on
said Parcel Plat; thence South 12 degrees 12 minutes 38 seconds West a distance of 25.50 feet to
'the point designated "302" on said Parcel Plat; thence South 00 degrees 54 minutes 02 seconds
West a distance of 70.00 feet to the point designated"322" on said Parcel Plat; thence North 89
degrees 05 minutes 58 seconds West a distance of 9.51 feet to the eastern boundary of
Pennsylvania Street and the point designated"323"on said Parcel Plat; thence North 00 degrees
54 minutes 03 seconds East a distance of 164.04 feet, along said eastern boundary of
Pennsylvania Street, to the southern boundary of 11 1''Street; thence South 89 degrees 50
Exhibit "A"
Sheet 2 of 2
Project: 1297165
Parcel: 63 Fee
Tax Id. No. 29-13-02-000-017.001-018
minutes 16 seconds East a distance of 122.01 feet, along said southern boundary,to the point of
beginning and containing 0.116 acres,more or less.
This description was prepared for the City of Carmel by Trent E. Newport, Indiana Registered
Land Surveyor, License Number 29600021, on the O�day of kviv$t, 2012.
E. N ' `�
sTER o'°o�,
TRENT E. NEWPORT
INDIANA LAND SURVEYOR
No. 29600021 NO. LS 29600021
STATE OF
e
qNa s u Po��
' Exhibit "1J " Sheet 1 of 2
t'
Right—of—Way Parcel Plat
Prepared for City of Carmel
By CrossRoad Engineers, P.C.
16+00 17+00 18+00 19+00 20+00
7
1
111th. 5 eet UNE B°
675.83' 1
of
------------- ------------- ---------------
3 --15-�--=----------Sell_0/1--- --------675.76' --------- v°
------ ----------------------------- -
I
O i ii
2 L20' esmt for gas
28.50 i /�� 0 19 line in favor of 5501
Indiana Gas
r u �
Company, Inc.
ii 0
O i u
r tr
O i ii 2
ii 10' Esmt for landscaping in favor
of the City of Carmel, Indiana
r n
2
O r ±r' 20' esmt for sewer line in
O Q --favor of Clay Township
+ j w 1 11 Regional Waste District
L0
IN ti .
r�
<}
Sell—Off
2 D' 120' 240'
O 1 h 1 WA Ma Roam
Scale: 1'= 120'
'4- 0 I
RS i
q ell—Off
RS �
4
r
q r
r
i
28.50'
15.00'
674.59'
� ,er �
U1 � 15' Esmt for storm sewer in
favor of Charter Arbor Indy
2 2 Behavioral Health Systems, LLC.
11 1 5502
Parcel: 63 Owner: J.B. & M.J.M. OF INDIANA, INC. Drawn By: J.WHITESIDE Date: 0810812012
Code: Checked By: R.PERRY Date: 0810812012
Project: 1297165 DES. No. 1297165
Road. 111th. ST& PENNSYLVANIA ST INST. 9709731965 DATE 08 05 1997
County: HAMILTON � Hatched Area is the INST. f 9008699 DATE:04181990
Section 2 Approximate Taking INST. 9008700 DATE 04/181990
Township: 17N INST. / 9427142 DATE: 06/15/1994
Range: 3E INST. 200300062249 DATE.• 0612712003
Note: Centerline Stationing is English
r c
Exhibit "B" Sheet 2 of 2
Right—of—Way Parcel Plat
Prepared for City of Carmel
By CrossRood Engineers, P.C.
Porcel Coordinate Chart (Shown in Feet)
Point Centerline Station Offset Northing Eastin
1
2
3
7 See Location Control Route Survey Plot
5501
5502
302 A' 146+45.00 65.00• R 9185.9128 5126.5264
303 A' 146+70.00 70.00' R 9210.8311 5131.9187
322 A' 145+75.00 65.00'R 9115.9214 5125.4262
323 A' 145+75.00 PL 55.49' R 9116.0709 5115.9157
304 16' 16+00.00 65.00'R 9254.9270 5175.4357
305 B' 16+15. 62.00' R 9257.8845 5190.4441
319 B' 16+30.00 62.00' R 9257.8421 5205.4440
320 9' 15+65.00 PL 40.00' R 9279.7418 1 5240.5062
Note: Stations & Offsets control over both North & East Coordinates and Bearings
& Distances.
To the best of my knowledge and belief, this plat, together with the 'Location Control Route a� E. N1;jy
Survey' recorded as Instrument Number 2010-015472 in the Office of the Recorder of Hamilton !�, �r,tSTEj? AQ
County, Indiana, (Incorporated and made a part hereof by reference) comprise a Route Survey �A
executed in accordance with Title 865 Indiana Administrative Code 1-12, (`Rule 12'). No* LS
29600021 � -
f
STATE OF Q.-
Trent E. Newport Dote O
Reg. Land Surveyor No. 29600021 9,y 7NDIAN1 y
State of Indiana v Transportation k
S U R Developyment Consultants
Slt7 AERi1W UFaI au�E N 46107
1J1 7r
Parcel: 63 Owner: J.B. & M.J.M. OF INDIANA, INC. Drawn By: J.WHITESIDE Date: 08/08/2012
Code: Checked By: R.PERRY Date: 08/08/2012
Project: 1297165 DES. No. 1297165
Road: 111th. ST & PENNSYLVANIA ST. INST. 9709731965 DATE 0810511997
County: HAMILTON f
Section 2 Hatched Area is the INST. 9008699 DATE:04 18 1990
Township: 17N Approximate Taking INST. 9008700 DATE: 0411811990
Range: 3E INST. 9427142 DATE: 0611511994
Note: Centerline Stationing is English INST.. 200300062249 DATE: 06 27/2003 Dirnens
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
��`�• `' �� oc— -1ACA1 Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Y\1 St- �c�� 72 00 00
•r v C — 20 0 O
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 $
To o N . ?\and / z Ste, tZjc�o
$ _T:L3do
ON ACCOUNT OF APPROPRIATION FOR
n 7
Board Members
PO#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
2 X50 z. qb2 �"�-3�o y�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
3 20
Signature
i I �_✓
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund