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Ebenisterie Beaubois Ltee - $311,248.97
• Disbursement instructions (PAC Millwork) Regions Bank hereby is instructed to make a disbursement of Loan Proceeds from the Borrower Loan Account to (or for the account of)Borrower in: (a)the amount of the "Total Authorized Disbursement" line in the "Amount of Authorized Disbursement"column below;and (b) accordance with the terms and conditions of the Agreement,the other Loan Documents, and the Disbursement Instructions. Purpose of Authorized Disbursement Amount of Authorized Disbursement :� iludi fihnun' 1'o e PQ1 br i�iIh,,e RhAncink f0 7/7. 41 l,uls 6+ho+,ni- fo �ttid �`1 '3 Vie¢ tihakial J904,5304 Total Authorized Disbursement �� t d`'l l-� 5 All terms used in these Disbursement Instructions without definition shall have the meanings ascribed thereto in that certain Loan Agreement(PAC Millwork),dated January 28,2010,by and between Lender and Village Financial, LLC. Dated: 4i7 /L./ V CITY OF CARMEL REDEVELOPMENT COMMISSI•N Printed L es S: 811s Title EXec.0 it1P i1 reCT0t' / TM ` Document 6702/CMa —1992 Application and Certificate for.Payment Construction•.Manager-Adviser Edition , TO OWNER:NER: ' PROJECT: APPLICATION NO: -U;IL Distribution to: �)�RI �'� Ca role PERIOD TO Q l° 3 i 2-0)D OWNER ❑ �c We,I 119Gt C 0015+ . 1 1 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: - CONTRACT DATE: ARCHITECT ❑ Eben 151er►0 �'0(-A CIS f!tee jhfQI AiGlf) PROJECT NOS: ZPg5 /.50- 0 / CONTRACTOR ❑ sit coril '4ve. . VIA ARCHITECT: FIELD ❑ Sr.-&GOR.C4 CJew'` - CAA i . CONTRACT FOR: I I I I;U(�i1 . Us11 0441 -Ci Orchi iPc`IS ❑ CONTRACTOR'S.APPLICATION FOR PAYMENT The undersigned Contractor certifies that'to 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 Application for Payment has been completed in accordance with the Continuation Sheet,AIA Document G703,is attached. d Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and.payments received from the Owner, arid that current 1.ORIGINALCONTRACT SUM $ /'4'o 70 payment show. •- ein is now due. - 2.Net change by Change Orders $ =•,7,g 6,63 c"t' CONTRA OR - 3.CONTRACT SUM TO DATE(Line 1 ±2) $-rj/q k5°' •By: A a � Date: 01-1 2(j /20/0 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ ,9576/6.-3S State o • be,FCC Commissaire a I'Assermentation 5.RETAINAGE Co my of: (� Commissioner for Oath a. ((7 %of Completed Work 2 Subscribed and sworn to before (Column D+Eon G703) $' 33 71 i. d y me this 20 ,day of Aq bOr9 2010 Manon Poulin b. °lo of Stored Material Notary Public - ;. # 163 850 (Column F on G703) $ !. c/ My Commission expires: f (�V /0 a�10 District Beauce-Quebec Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ ���(p� CERTIFICATE FOR PAYMENT Beauce-Quebec District f� �,// In-accordance with the Contract Documents, based on-on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $�� 07/` �� this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) /0 IG knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ , 19'6 )%37' accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6•from prior Certificate) CERTIFIED. 0 8.CURRENT PAYMENT DUE $ /0 71!ry- 6) i AMOUNT CERTIFIED $ `D` 7/7. ,) 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and o e Continuation S eet t changed to conform with the amount certified.) (Line 3 less Line 6) s�(5•9c2 860.. a.a 6/. CONS -UCTION tIV, :'. I ' • l BY: , .: 4�r1/ �� ® Date: ®1/Z)/ /O ADDITIONS DEDUCTIONS •'r CHANGE ORDER SUMMARY ARCH ECT: � ft�T /+, -7 ,,ll Total changes approved in previous months by Owner $ - $ By; j I l --- Date: C)I i ()Li;c7 O'0 Total approved this Month • $ $ • This Certificate is not negotiable. The AMOUNT CERTIFIED is.payable only to the Contractor TOTALS' $ named herein: Issuance payinent and acceptance of payinent are without prejudice'to any rights of NET CHANGES by Change Order $ the Owner or Contractor 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 G702/CMaTM—1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this Ale Document,or any portion of it,may result in severe civil and criminal penalties,and will be 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. CONTINUATION SHEET AIA Document G703 Format AIA Doc.G702,APPLICATION AND CERTIFICATE FOR PAYMENT Contractor:Ebenisterie Beaubois Ltee containing Contractor's signed Certification is attached. APPLICATION NO:12 In tabulations below,amounts are stated to the nearest dollar. APPLICATION DATE:01/20/2010 Use Column I on Contracts where variable retainage for line items may apply. APLICATION PERIOD:01/01/2010-01/31-2010 ARCHITECTS PROJECT NO: Carmel Regional Performing Arts Center,Carmel,IN A B C D I E F G H I Work Completed Material Total Item Description Scheduled Previous This Presently Complete % Balance Retainage Value application Period Stored and stored to Finish 10% No. of work (D+E) (not in D or E) (D+E+F MAT BASEMENT LEVEL 52 098.35$ 0.00$ 0.00$ 0.00$ 0.00$ 52 098.35$ 0.00$ LAB 11 883.71 $ 0.00$ 0.00$ 0.00$ 0.00$ 11 883.71 $ 0.00$ MAT North 6 886.93$ 0.00$ 0.00$ 0.00$ 0.00$ 6 886.93$ 0.00$ MAT Miscellaneous items 45 211.43$ 0.00$ 0.00$ 0.00$ 0.00$ 45 211.43$ 0.00$ LAB North 1 257.05$ 0.00$ 0.00$ 0.00$ 0.00$ 1 257.05$ 0.00$ LAB Miscellaneous items 10 626.66$ 0.00$ 0.00$ 0.00$ 0.00$ 10 626.66$ 0.00$ MAT PLENUM LEVEL 49 668.53$ 0.00$ 0.00 $ 0.00$ 0.00$ 49 668.53 $ 0.00$ LAB 42 456.67$ 0.00$ 0.00$ 0.00$ 0.00$ 42 456.67$ 0.00$ MAT Miscellaneous items 12 287.66$ 0.00$ 0.00$ 0.00$ 0.00$ 12 287.66$ 0.00$ MAT South 37 380.88$ 0.00$ 0.00$ 0.00$ 0.00$ 37 380.88$ 0.00$ LAB Miscellaneous items 26 524.29$ 0.00$ 0.00$ 0.00$ 0.00$ 26 524.29$ 0.00$ LAB South 15 932.38$ 0.00$ 0.00$ 0.00$ 0.00$ 15 932.38$ 0.00$ MAT ORCHESTRA LOW LEVEL 884 071.73 $ 0.00$ 0.00$ 0.00$ 0.00 $ 884 071.73$ 0.00$ LAB 317 235.98 $ 0.00$ 0.00$ 0.00$ 0.00 $ 317 235.98$ 0.00$ MAT Auditorium 536 641.30$ 0.00$ 0.00$ 0.00$ 0.00$ 536 641.30$ 0.00$ MAT East 137 103.55$ 0.00$ 0.00$ 0.00$ 0.00$ 137 103.55$ 0.00$ Page 1 CONTINUATION SHEET AIA Document G703 Format AIA Doc.G702,APPLICATION AND CERTIFICATE FOR PAYMENT Contractor:Ebenisterie Beaubois Ltee containing Contractor's signed Certification is attached. APPLICATION NO:12 In tabulations below,amounts are stated to the nearest dollar. APPLICATION DATE:01/20/2010 Use Column Ion Contracts where variable retainage for line items may apply. APLICATION PERIOD:01/01/2010-01/31-2010 ARCHITECT'S PROJECT NO: Carmel Regional Performing Arts Center,Carmel,IN A B C D I E F G H I Work Completed Material Total Item Description Scheduled Previous This Presently Complete % Balance Retainage Value application Period Stored and stored to Finish 10% No. of work (D+E) (not in D or E) (D+E+F) (G/C) (C-G) MAT North 101 619.95$ 0.00$ 0.00$ 0.00$ 0.00$ 101 619.95$ 0.00$ MAT West 50 922.96$ 0.00$ 0.00$ 0.00$ 0.00$ 50 922.96$ 0.00$ MAT Miscellaneous items 57 783.98$ 0.00$ 0.00$ 0.00$ 0.005 57 783.98$ 0.00$ LAB Auditorium 161 191.08$ 0.00$ 0.00$ 0.00$ 0.00$ 161 191.08$ 0.00$ LAB East 40 499.18$ 0.00$ 0.00$ 0.00$ 0.00$ 40 499.18$ 0.00$ LAB North 16 932.65$ 0.00$ 0.00$ 0.00$ 0.00$ 16 932.65$ 0.00$ LAB West 26 471.63$ 0.00$ 0.00$ 0.00$ 0.00$ 26 471.63$ 0.00$ LAB Miscellaneous items 72 141.44$ 0.00$ 0.00$ 0.00$ 0.00$ 72 141.44$ 0.00$ MAT ORCHESTRA HIGH LEVEL 132 847.59$ 0.00$ 0.00$ 0.00$ 0.00$ 132 847.59$ 0.00$ LAB 92 280.19$ 0.00 $ 0.00$ 0.00$ 0.00$ 92 280.19$ 0.00$ MAT Auditorium 4 621.74$ 0.00$ 0.00$ 0.00$ 0.00$ 4 621.74$ 0.00$ MAT East 485.32$ 0.00$ 0.00$ 0.00$ 0.00$ 485.32$ 0.00$ MAT South 101 013.48$ 0.00$ 0.00$ 0.00$ 0.00$ 101 013.48$ 0.00$ MAT West 485.32$ 0.00$ 0.00$ 0.00$ 0.00$ 485.32$ 0.00$ MAT Miscellaneous items 26 241.73$ 0.00$ 0.00$ 0.00$ 0.00$ 26 241.73$ 0.00$ Page 2 • CONTINUATION SHEET AIA Document G703 Format AIA Doc.G702,APPLICATION AND CERTIFICATE FOR PAYMENT Contractor:Ebenisterie Beaubois Ltee containing Contractor's signed Certification is attached. APPLICATION NO:12 In tabulations below,amounts are stated to the nearest dollar. APPLICATION DATE:01/20/2010 Use Column I on Contracts where variable retainage for line items may apply. APLICATION PERIOD:01/01/2010•01/31-2010 ARCHITECTS PROJECT NO: Carmel Regional Performing Arts Center,Carmel,IN A B C D I E F G H I Work Completed Material Total Item Description Scheduled Previous This Presently Complete % Balance Retainage Value application Period Stored and stored to Finish 10% • No. of work (D+E) (not in D or E) (D+E+F) (G/C) (C-G) LAB Auditorium 2 262.18$ 0.00$ 0.00$ 0.00$ 0.00$ 2 262.18$ 0.00$ LAB East 381.52$ 0.00$ 0.00$ 0.00$ 0.00$ 381.52$ 0.00$ LAB South 40 723.56$ 0.00$ 0.00$ 0.00$ 0.00$ 40 723.56$ 0.00$ • LAB West 381.52$ 0.00$ 0.00$ 0.00$ 0.00$ 381.52$ 0.00$ LAB Miscellaneous items 48 531.41$ 0.00$ 0.00$ 0.00$ 0.00$ 48 531.41$ 0.00$ MAT BOX TIER LEVEL 326 347.94$ 4 423.24$ 0.00$ 0.00$ 4 423.24$ 321 924.71 $ 442.32$ LAB 278 078.48$ 0.00$ 0.00$ 0.00$ 0.00$ 278 078.48$ 0.00$ MAT Auditorium 11 727.05$ 0.00$ 0.00$ 0.00$ 0.00$ 11 727.05$ 0.00$ MAT East 44 650.44$ 4 423.24$ 0.00$ 0.00$ 4 423.24$ 40 227.20$ 442.32$ MAT North 16 580.44$ 0.00$ 0.00$ 0.00$ 0.00$ 16 580.44$ 0.00$ MAT South 81 787.06$ 0.00$ 0.00$ 0.00$ 0.00$ 81 787.06$ 0.00$ MAT West 82 441.76$ 0.00$ 0.00$ 0.00$ 0.00$ 82 441.76$ 0.00$ MAT Miscellaneous items 89 161.20$ 0.00$ 0.00$ 0.00$ 0.00$ 89 161.20$ 0.00$ LAB Auditorium 6 058.74$ 0.00$ 0.00$ 0.00$ 0.00$ 6 058.74$ 0.00$ LAB East 26 800.35$ 0.00$ 0.00$ 0.00$ 0.00$ 26 800.35$ 0.00$ LAB North 6 898.68$ 0.00$ 0.00$ 0.00$ 0.00$ 6 898.68$ 0.00$ Page 3 • CONTINUATION SHEET AIA Document 6703 Format AIA Doc.G702,APPLICATION AND CERTIFICATE FOR PAYMENT Contractor:Ebenisterie Beaubois Ltee containing Contractor's signed Certification is attached. APPLICATION NO:12 In tabulations below,amounts are stated to the nearest dollar. APPLICATION DATE:01/20/2010 Use Column Ion Contracts where variable retainage for line items may apply. APLICATION PERIOD:01/01/2010-01/31-2010 ARCHITECT'S PROJECT NO: Carmel Regional Performing Arts Center,Carmel,IN A B C D I E F G H I Work Completed Material Total Item Description Scheduled Previous This Presently Complete % Balance Retainage Value application Period • Stored and stored to Finish 10% No. of work ID+E) . (not in D or E) (D+E+F) (G/C) (C-G) LAB South 37 667.50$ 0.00$ 0.00$ 0.00$ 0.00$ 37 667.50$ 0.00$ LAB West 42 037.97$ 0.00$ 0.00$ 0.00$ 0.00$ 42 037.97$ 0.00$ LAB Miscellaneous items 158 615.24$ 0.00$ 0.00$ 0.00$ 0.00$ 158 615.24$ 0.00$ MAT BALCONY LOW LEVEL 30 066.12$ 0.00$ 0.00 $ 0.00$ 0.00$ 30 066.12$ 0.00$ LAB 48 121.87$ 0.00$ 0.00 $ 0.00$ 0.00$ 48 121.87$ 0.00$ MAT Auditorium 5 584.31$ 0.00$ 0.00$ 0.00$ 0.00$ 5 584.31$ 0.00$ MAT East 849.32$ 0.00$ 0.00$ 0.00$ 0.00$ 849.32$ 0.00$ MAT Norht 242.66$ 0.00$ 0.00$ 0.00$ 0.00$ 242.66$ 0.00$ MAT South 4 378.44$ 0.00$ 0.00$ 0.00$ 0.00$ 4 378.44$ 0.00$ MAT West 849.32$ 0.00$ 0.00$ 0.005 0.00$ 849.32$ 0.00$ MAT Miscellaneous items 18 162.07$ 0.00$ . 0.00$ 0.00$ 0.00$ 18 162.07$ 0.00$ LAB Auditorium 2 674.80$ 0.00$ 0.005 o.00$ 0.00$ 2 674.80$ 0.005 LAB East 667.66$ 0.00$ 0.00$ 0.00$ 0.00$ 667.66$ 0.00$ LAB North 190.76$ 0.00$ 0.00$ 0.00$ 0.00$ 190.76$ 0.00$ LAB South 2740.40$ 0.00$ 0.00$ 0.00$ 0.00$ 2740.40$ 0.00$ LAB West 667.66 S 0.00$ 0.00$ 0.00$ 0.00$ 667.66$ 0.00$ Page 4 • CONTINUATION SHEET AIA Document G703 Format AIA Doc.G702,APPLICATION AND CERTIFICATE FOR PAYMENT Contractor:Ebenistorie Beaubois Ltee containing Contractor's signed Certification is attached. APPLICATION NO:12 In tabulations below,amounts are stated to the nearest dollar. APPLICATION DATE:01/20/2010 Use Column I on Contracts where variable retainage for line items may apply. APLICATION PERIOD:01/01/2010-01/31-2010 ARCHITECTS PROJECT NO: Carmel Regional Performing Arts Center,Cannel,IN A B C D I E F G H I Work Completed Material Total Item Description Scheduled Previous This Presently Complete % Balance Retainage Value application Period Stored and stored to Finish 10% No. of work (D+E) (not in D or E) (D+E+F) (G/C) (C-G) LAB Miscellaneous items 41 180.59$ 0.00$ 0.00$ 0.00$ 0.00$ 41 180.59$ 0.00$ MAT BALCONY HIGH LEVEL 143 538.52$ 0.00$ 0.00$ 0.00$ 0.00 $ 143 538.52$ 0.00$ LAB 105 766.53$ 0.00$ 0.00$ 0.00$ 0.00$ 105 766.53$ 0.00$ MAT Auditorium 6701.17$ 0.00$ 0.00$ 0.00$ 0.00$ 6701.17$ 0.00$ MAT East 8 672.67$ 0.00$ 0.00$ 0.00$ 0.00$ 8 672.67$ 0.00$ MAT North 121.33$ 0.00$ 0.00$ 0.00$ 0.00$ 121.33$ 0.00$ MAT South 85 647.88$ 0.00$ 0.00$ 0.00$ 0.00$ 85 647.88$ 0.00$ MAT West 5 840.25$ 0.00$ 0.00$ 0.00$ 0.00$ 5 840.25$ 0.00$ MAT Miscellaneous items 36 555.23$ 0.00$ 0.00$ 0.00$ 0.00$ 36 555.23$ 0.00$ LAB Auditorium 3 504.20$ 0.00$ 0.00$ 0.00$ 0.00$ 3 504.20$ 0.00$ LAB East 5 910.02$ 0.00$ 0.00$ 0.00$ 0.00$ • 5 910.02$ 0.00$ LAB North 95.38$ 0.00$ 0.00$ 0.00$ 0.00$ 95.38$ 0.00$ LAB South 39 165.15$ 0.00$ 0.00$ 0.00$ 0.00$ 39 165.15$ 0.00$ LAB West 3 896.68$ 0.00$ 0.00$ 0.00$ 0.00$ 3 896.68$ 0.00$ LAB Miscellaneous items 53 195.10$ •0.00$ 0.00$ 0.00$ 0.00$ 53 195.10$ 0.00$ MAT ALLOWANCE 105 000.00$ 0.00$ 0.00$ 0.00$ 0.00$ 105 000.00$ 0.00$ Page 5 CONTINUATION SHEET AIA Document G703 Format AIA Doc.G702,APPLICATION AND CERTIFICATE FOR PAYMENT Contractor:Ebenisterie Beaubois Ltee containing Contractor's signed Certification is attached. APPLICATION NO:12 In tabulations below,amounts are stated to the nearest dollar. APPLICATION DATE:01/20/2010 Use Column Ion Contracts where variable retainage for line items may apply. APLICATION PERIOD:01/01/2010-01/31-2010 ARCHITECT'S PROJECT NO: Carmel Regional Performing Arts Center,Carmel,IN A B C D I E F G H I Work Completed Material Total Item Description Scheduled Previous This Presently Complete % Balance Retainage Value application Period Stored and stored to Finish 10% No. of work (D+E) (not in D or E) (D+E+F) (G/C) (C-G) 5060 General Allowance 50 000.00$ 0.00$ 0.00$ 0% 50 000.00$ 0.00$ 5060 CAD Allowance 5 000.00$ 0.00$ 0.00$ 0% 5 000.00$ 0.00$ 5070 General Allowance 25 000.00$ 0.00$ 0.00$ 0% 25 000.00$ 0.00 5 5070 CAD Allowance 5 000.00$ 0.00$ 0.00 5 0% 5 000.00$ 0.00$ 5080 General Allowance 15 000.00$ 0.00$ 0.00$ 0% 15 000.00$ 0.00$ 5080 CAD Allowance 5 000.00$ 0.00 5 0.00 5 0% 5 000.00$ 0.00$ SUB TOTAL 2 619 462.22$ 4 423.24$ 0.00$ 0.00$ 4 423.24$ 2 615 038.98$ 442.32$ Administration Fees MAT Shop Drawings 174 383.84$ 174 383.84$ 0.00$ 174 383.84$ 100% 0.00$ 17 438.38$ INST MAT Engeneering and cutting sheet 116 255.86$ 46 502.34$ 3 487.68$ 49 990.02$ 43% 66 265.84$ 4 999.00$ INST MAT Bond 20 325.26$ 20 325.26$ 0.00$ 20 325.26$ 100% 0.00$ 2 032.53$ INST MAT Projet Management/Living/Travel 125 378.55$ 56 420.35$ 2 507.57$ 58 927.92$ 47% 66 450.63$ 5 892.79$ INST MAT Superintendant/Living/Travel 118 264.27$ 23 652.85$ 5 913.21$ 29 566.07$ 25% 88 698.20$ 2 956.61$ INST TOTAL BASE CONTRACT 3 174 070.00$ 325 707.89$ 11 908.46$ 0.00$ 337 616.35$ 2 836 453.66$ 33 761.63$ Change Orders MAT Change order#001 $ 5 156.00 0.00 5 0.00 5 0% 5 156.00$ 0.00$ INST Change order#002 $ 17 479.00 0.00$ 0.00$ 0% 17 479.00$ 0.00$ MAT INST TOTAL CHANGE ORDERS $ 22 635.00 $ - $ - $ - $ - $ 22 635.00 $ - I TOTAL I$ 3 196 705.001$ 325 707.89 I$ 11 908.46 I$ - I $ 337 616.35 I I $ 2 859 088.66 I $ 33 761.63 ' i' C kuler M~atrice 7 Page 6 SL Subcontract Billing Report For Work Invoiced From 01/01/10 to 01/31/10 Wei Subcontract 2695=5070 5070 Custom Casework Job: 2695- Carmel-RPAC Construction Vendor: 9846 EBENISTERIOA BEAUBOIS LTEE 777 3rd Ave. SW Carmel, IN 46032 , Contract To Date This:Period Item Units UM Unit Cost Amount Units/% Amount Units/% Amount 1 5070 Custom Casework LS 3,174,070.00 10.64% 337,616.35 0.38% 11,908.46 Total Contract Items 3,174,070.00 337,616.35 11,908.46 ***Change Orders*** 2 Bid Alternate-Donor Amenity LS 17,479.00 0.00%. 0.00 0.00% 0.00 Upgrades 3 Bid Alternate-Multipurpose LS 5,156.00 0.00% 0.00 0.00% 0.00 Room Upgrades 4 SSC-1227 Allowance LS -66,300.00 0.00% 0.00 0.00% 0.00 reductions Total Change Order Items -43,665.00 0.00 0.00 Subcontract Totals: 3,130,405.00 337,616.35 11,908.46 Total Billings: 337,616.35 11,908.46 Unpaid Retainage: 33,761.64 1,190.85 Discounts: 0.00 0.00 Net Billings: 303,854.71 10,717.61 98 SSC-CMa Projects Page 1 01/22/10 08:54:19 AM Date Format-MM/DD/YY SLSubBillingReport.rpt , {iii, A\ I TM Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: APPLICATION NO: 01 3 Distribution to: Of ki oi' ,(?trael l/Qrrm 1 RPO C (?y)5 • PERIOD TO:c)ZJ2e,120)0 OWNER CI CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA.CONSTRUCTION MANAGER: CONTRACT:DATE: ARCHITECT ❑ £ITh i rle le Ctrl L.t S h ie I J)(1-011 PROJECT NOS: /at/5 1 rj•'ilo / CONTRACTOR ❑ ;5zzi, to th Cl t Dec c.s' o'-li VIA ARCHITECT: FIELD ❑ CONTRACTFOR: ri i I 1."(A/Of lc CSQ 0rch i?c-1.5 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to 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.Application for Payment has been completed in accordance with the Continuation Sheet,AlA Document G703,is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous ,/ r c Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $'j,/71f Q?U payment shown rerein is:now due. 2.Net change by Change Orders $ e9,9 G. 5.° CONT• • OR: — 3.CONTRACT SUM TO DATE(Line I ±2) $A./gin °t By: " p Date:n„Z//ljl�'U/O 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ (�'//=�1O State of:' CC / 5:RETAINAGE: Coun of:i 'Ci VC e • a. %of Completed Work _ p/ Subscribed and sworn to before Commissaire.a I'Assermentation (Column D+Eon G703) $ 6j/ /`3 me this ISEh day of 4:c.bVc7+1) • 010 Commissioner for oath b. %,of Stored Material Notary Public:4 (MN: (j,� Manon Poulin (Column F on G703) $ My Commission expires: MG1,/ I o o�OIO i1 .}53 8 O cv Y Total Retainagc(Lines 5a+5b or Total in Column I ofG703).. $ 6./ /5L CERTIFICATE FOR PAYMENT District Beauce-QuObec 0.7. In accordance with the Contract Documents,based on,on=. t comprising 6.TOTAL EARNED LESS RETAINAGE $_‘101/M6, � t��chat to�.c this application,the Construction Manager and Architect certify to the caner that to.t to best of their (Line=1'Less Line 5`Total) knowledge,information and belief the'Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT .6Cht .5i/ 7/ 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 $ 7al 5.3i•- • AMOUNT CERTIFIED $ 331531 •` G. 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach a planatiau if amount certified differs from the amount applied.Initial all figures on this Application and on tie Continuation Sheet t/, changed to conform with the amount certified.) (Line 3 less Line 6) $,- 519,-• CONST' C T I O N M G/ / BY: �m. �r `.Q 11 v. — Date: g,,j"� /O CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHIT C • (f Total changes approved in previous months by Owner $ $ n I Ir By Date: t7 w Total approved this Month $ �$ This Certificate is not negotiable. The AMOUNT CERTIFIED is;payable on y to the Contractor TOTALS $ $ named herein. issuance. payment.and'acceptance of payment are without:prejudice to any rights of NET CHANGES by Change Order $ the Owner or Contractor under this Contract. CAUTION:You should.signran-original AIA;Contract.Document,on which this text;appears in RED An original assures that will not be.obscured. AM Document G702/CMa nA_1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING.This AlA®:Document isprotected;by U.S.Copyright Law and international"Treaties.. Unauthorized reproduction or distribution of this AlAe Document,,or any portion of it,may result in severe;civil`and:criminal penattles,.andwill be prosecuted to the'maximum extent possible under the.law. Purchasers are permitted to reproduce ten i10)copies of this document when completed.To report copyright violations of AlA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. CONTINUATION SHEET .AIA Document 0703 Forme[' Ali Dec..0705,APPLICATION AMID CERTIFICATE,FOR PAYMEIIT Contractor:Ebenisterlo Beaubols Ltee containing Contraclol's signed Certification Is attached. APPLICATION.NO:.13 In tabulations below,.amounts are stated to the nearest dollar. APPLICATION DATE::02/ZO/Z010 Use Column Ion Contracts vdier'e variable retainage for line items may apply. APLIcATION PERIOD:-0Z/01/2010-02/28-2010 ARCHITECT'S PROJECT.NO: Carmel Regional Performing Arts Center,Carmel,IN A 9 C. •0 I E F G. H I Work Completed Material Total. Item Description 'Scheduled Previous This presently' Complete % Balance Retainage Value: application Period Stored and stored to Finish 10% ;No. of:wark (0+E) (notleDorEl' (D-+,E+'F) ' (G/'C) (C-0) MAT BASEMENT LEVEL 52 098.35$ '0.00$ 0.00$ 0:005 0.00$ 52 098.35$ 0:005 LAB 11.883.71 $ 0.00$ 0.00$ 0.00$ 0.00$ 11 883.71 $ 0.00$ MAT North 6'886:93$ '0.00.$ 0.00$ 0.00'$ 0:00 S 6.806.93$ 0.00$ MAT .Miscellaneous items '45 21.1.43.$ 0:00 S, 0.00 5, 0.00 5. 0.00$ 45'211.43$ 0.00.5 LAB North 1.257:05$ '0.005 '0.00 5 0.00 5 `0.00$ 1 257.05 5 0.00$ L.AB. Miscellaneous items 10 626.66S 0:00 5 .0.00 5 0.00 5 0.005 10 626.66.5 0.00..$ MAT PLENUM LEVEL 49 668.53 $ '0.00$ .0.00$' 1'1 058:89$ 11 058.89'$ 38 609.64$ 1 105:89.$ LAB 42 456.67$ 0.00$ 0.00$ 0.00$ 0.00,$ 42.456.67.5 0.00.$ MAT Miscellaneous items 12 287.66$ 0.00 S 0.005 11,058.89 S 11 058.89 5 1128.77 5 1 105.89.$ MAT South 37 380.88'S '0:005 0.00'$, 0.00$ 0.00.5. 37380.88 S 0.00$ . LAB Miscellaneous items '26 524.29 S .0.00$ 0.00$ 0.00 5 0.00 5 26'524.29 S 0.00 S LAB South 15'932.38:S 0.00$ .0.005 0.00$ 0.00$ :15932.38.$ 0.00$ MAT ORCHESTRA.LOW LEVEL '.884 071.73$ '0.00 5' 0.00$ 121 639:88$ 121'639588,.$ 762`43,1.86`$ 12 163.99$ LAB .317'235.98$ 0.00$ 0.00$ 0.00$ 0:00:,$ 317'235.98$ 0.00`$ 'MAT Auditorium :536 641.30'.$ 0.00$ `0.00.5 34 919.88$ 34.919:88.5 501:721.42:5 3 491.99 5 'MAT East 137 103.55,$ 0.005. 0.005 '29 122.48$ 29.122.48 5 107,981.07 5 2 912.25.$ Page 1 CONTINUATION.SHEET AIA Document G70)Format A1A Doc.G702,APPLICATI011.AND CERTIFICATE FOR PAYMENT Contractor::Ebenisterie-Beaubols Lteo containing Contractor's signed Certification is attached: APPLICATION.NO:13- InaibulnUons below,amounts nre stated to the nearest dollar: APPLICATION DATE:02/20/2010. Use ColumnI on Contracts where variable relninage for line Items may apply. 'APUCATION-PERIOD:412/01/2010.-02/20.2010 ARCHITECTS PROJECT NO: Carmel Regional Performing Arts Center,Carmel,IN ,A B c D I :E' 'P G' H 1 Work Completed Material Total' Item Description. Scheduled Previous. This Presently Complete ' % Balance RetainaRe. Value- application Period. Stored and stored to Finish 10% No. I of work- (D':+E). (not in.D!arE); (O.+E't-F) (G'/'C) (C--G) MAT' North 101,6,19.95$ 0.00$ 0.00,5. 4 718.845; 4.748:84.5. 96901.11:$ 471.88$ MAT West 50"922:96$ 0.003 0.00.5 '2056.05,5' 2 056.05$ 48 866 90 5 205.61$ MAT. Miscellaneous items 57.7B3.98.5 O00':$ 0:00:$ 50822:63.$ 50 822.63;$ 6-961:35 S 5'082.26$ LAB Auditorium- 161'191.083 0:00 5 0.00:5 '0:00'5 I 0:00$ 161 191.08 S 0.00$ LAB': East 40-499.18 S 0.00=$ 0:00;S '0.00$ '0:00 S 40:499.18'$ '0:00 5 LAB North 16'932.65 S 0:005 o,00 S 0:00:5 0.00'5 16 93265.$ 0.00'5 LAD' West. 26'471.63 S 0.00.5 0.00,5 0.00'$ . 0.00`$ 26.471.63$ 0.00$ LAB ' Miscellaneous'items 72141:44 5 0.00$ 0.005 0.00:$ 0.00'S 72 141.44$ 0.00.5 MAT ORCHESTRA:HIGH>LEVEL. 132'847.59.$ 0:00,$ 0:-00:$ 28,900.83$ 28 900:83$ 103 946.76$ 2:890.08$ LAB `92?280.19'$ 0.00;$ 0:00.$ 0:00$ 0:00'$_, 92 280:19$ 0.00'$ -MAT Auditorium 4 621174;5 0.005 0.00._$ 13.00;$ 0.00'$ 4:621:74$ .0.00:5 MAT East. 485.32:$ 0.00'5 0.00 5 0.003 0.00:5 :485.32$ .0.005 MAT South 101 013.48;$ 0.00'5 ,0,00 5 6.621.64,5 6 621.64$ 94:391.84 5 662:16 5 `MAT ,West` 485.32'$ '0.005 -0:00.5 0:00$ 0.00;$ 485.3Z'5 -0,00'$ MAT Miscellaneous items 26.241:7335 :0:005 •0:00$, '22;279,1915 22274,19'5 3:.962.54:5 2.227.92'5 Page 2 CONTINUATION SHEET AIA-Document G703 Format AlA Doc.;0702,APPLICATION AND.CERTIFICATE FOR PAYMENT Contractor:::Ebenlsterie:Boaubois.Ltee containing Contractor's signed Cerlilicilonis attached. APPLICATION NO 13 In tabulations below,amounts are stated to the nearest dollar: APPUCATION DATE:,02/20/2010 Use.Column.I.on Contracts v here variable relnlnage.for(Inc itcrns,may:apply. APUICATION PERIOD:0270112010-02/28.2010 ARCHITECTS'PROJECT NO: Carmel Regional.Perrorriring Arts Center,.Carmel,iN 0. C 'D I Work Completed Material Total Item Description Scheduled Previous: This Presently. Complete .% Balance 'Retainage Value application 'Period Stored' and stored to Finish 10% No. of-work' (0+E) (not In 0 or.Ey (0+E'+F) (G kg., (C•G) LAB Auditorium 2.262.18.$ 0.00:$ 0.012$ 0.00$ X0.00:5 2'.262:18'5 0.00'$ , LAB East '381.52.5 0:00$ 0.00$ 0.005 0.00:$ 381.52$ 0.00$ LAD South 40 723.56$ 0:00$ 0,00:5 0:00:$ 0.00:$ 40-::723.56.$ 0:00$ LAD West ,381.52:5 0:00,5 0.00.5 0.00 S• 0:00.5 301:52.$ 0.00$ LAB Miscellaneous.items 48`531.41 S 0.00 S o,00:$ o.o0$ 0.00:$ 48 531.415 0.00.$ MAT BOX'TIER.LEVEL 326.347:90 4 423:24.$ 0:00$ 109'353.92$ 1:13 777::16$ '212.570.78$ 11 377:72$ LAB 278,078.48'$ 0.011$ 0:00'$ 0.00$ 0.00$ 278 078.48$ 0.00.$ MAT Auditorium 4.1 727.05 5 0.00'5 0.005 0.00$ o.do_$ 11'727.05 5 o:00'S MAT East 44.650:445 4 423.24 S 0.0125 204'45.90$ ..24 869.14•5 19'781.30:$ 2:486.9115 .MAT •North: .16'.580544'5 0.00..5 0.00.5 0.005 0.00$ 16.580.445 ,0:00.S ,MAT .South:! 81787.06'5 0:00'5 0.00'$ 8 113:45':$ 8 113.45:.$ • 73 673.61'$ 811:34$ :MAT West. 82 441:76.5• 0.00,5 0.00.S 549.50:5, 549:50'$ 81892.26x$ .54.95•$ MAT Miscellaneous'items 89 161..205 0.00$ 0.00$ :80 245.08:$ '80 245.08.$ 8'916.121$ 8'024.51'5 :LAO Auditorium 6'058.74.5: 0.00'$ 0.00$ 0.00:$ 0.00:5 6:058.74'5 0.00$ LAB` East 26'800535:$ 0.005 0.00.5 0:00':5 0.00.5 26 800:35'.$ 0.005 LAB' North 6 898.68;5. •0.00;$ .0.00.5 0.00-5 0.00$ L 6898:68'$ 0:00.5 Pape3 CONTINUATION SHEEP MA Document 6703 Format MA Doe.6702,APPLICATION MID CERTIFICATE FOR PAYMENT Contractor:Ebenisterle 8eaubols Ltee containing Contractor's signed Certification is attached. 'APPLICATION NO:13 In tabulations below,amounts are stated to the nearest dollar. APPLICATION DATE:02/20/2010 Use Column Ion Contracts where variable rehrinage for line items may apply. APLICATION PERIOD:02/01/2010.02/28.2010 ARCHITECTS PROJECT 140: Carmel Regional Performing Arts Center,Carmel,IN A B C D 1 E F G H I Work Completed Material Total Item Description Scheduled Previous This Presently Complete % Balance Retainag0 Value. application Period Stored and stored to Finish 10% No. of work (D+E) inot in D or El (D+E+F) (0/C) (C•G) LAB South 37 667.50 5 0.00$ 0.00.$ 0.00$ 0.00 5 37 667.50 5 0.00 5 LAB West 42 037.97$ 0.00$ 0.00$ 0.00 S 0.00$ 42 037.97$ 0.00$ LAB Miscellaneous items 158 615.24$ 0.00 5 0.00$ 0.00 5 0.00 5 158 615.24 S 0.005 MAT BALCONY LOW LEVEL 30 066.12$ 0.00$ 0.00$ 16 345.87$ 16 345.87$ 13 720.25$ 1 634.59$ LAB 48 121.87$ 0.00$ 0.00$ 0.00$ 0.00$ 48 121.87$ 0.00$ MAT Auditorium 5 584.31 5 0.00.5 0.00$ 0.00$ 0.00$ 5 584.31.5 0.00 5 MAT East 849.32$ 0,00 5 0.00$ 0.00 S 0.00 5 849.32$ 0.0D 5 MAT Norht 242.66$ 0.00 5 0.00 5 0.00 5 0.00 S 242.66$ 0.00 5 MAT South 4378.44 5 0.00 5 0.00 5 0.00$ 0.00 5 4 378.44$ 0.00$ MAT West 049.32$ 0.00 5 0.00 5 0.00 5 0.00 5 849.32$ 0.00 5 MAT Miscellaneous items 18 162.07$ 0.00 5 0.00 5 16 345.87$ 16.345,875 1 816.21 5 1 634.59$ LAB Auditorium 2674.80 5 0.00 5 0.00 5 0.00 5 0.00 5 2 674.80.5 0.005 LAB East 667.66$ 0.00 5 0.00$ 0.00$ 0.00$ 667.66 5 0.00 5 LAB North 190.76$ 0.00$ 0.00 S 0.00 S 0.00$ 190,76.5 0.00$ LAB South 2740.40$ 0.00$ 0.005 0.00$ 0.00$ 2740.40$ 0.00$ LAB West 667.66 5 0.00$. 0.00$ 0.00 5 0,00$ 667.66.5 0.00$ Page 4 CONTINUATION.SHEET AIA-DOCurner t 0703 Format A1A Doc.0702;APPLICATION:AND CERTIFICATE FOR PAYMENT .Contractor::Ebeniaterle.lieaubois Ltee. Containing CortUactin'ssigned Certification is attached.. APPLICATION NO:'.13 In tabulations below,anionnis are stated'to the nearest dollar. AP,PLICATION'DATE:02/20/2010 Use Column Ion Contracts where variable retalnageaor line Items may apply: APLICATION PERIOD:02/01/2010".02/28.2010 ARCHITECTS PROJECT NO: Carm cl Regional Ferjarming_Arts"Center,.Carmel,.)t A B I .0 D ' E i. F G'. H I ' Wor8Completed' 'Material Total Item• Description Scheduled Previous This Presently Complete % Balance .Retalnage. Value oppllcotlon Period Stored. -and stored to.Finish 10% No, of work" 10;+0) (not In Dor,El (D.:+'£:'+.F) (0/C) (C-G) LAB Miscellaneous items ,. ,ii 186:58•5 ',0.005 .0,00.5 '0.00,5 000:5 '41'180,59.5' 0,00$ .MAT BALCONY,HIGH LEVEL 143 538.52$ 0.00$ 0:00$ 34 624.66$ 34,624.66;$ 108,913.85"$ 3.462.47$ LAB 105 766.53'$ 0.00$ .0.00$ 0.00$ 0.00.$' 105'766.53$ 0[00:$ MAT Auditorium. 6'701.17:5 .0,00.5 0.00.5 'oioo$ 0.00:5 6;701.17'5,. 0.005 MAT East 8 672:67:5 0,00:5 . 0.00`5 0.005 0:00.5 8.672.67;.$ 0.00$ MAT' ; -North. 121.33t$. 0,00:5 0.00$ 0.00 5 0:005 121:33 5 0.00 5 MAT'' South 85 647.88$ .0.00 5 o:oo$ 1 724.96.$ 1 724:965. 83 922:917$ 172.50$ MAT West 5 840.25.5 0.00 5 0.00$ 0.00:5 0.005. 5:840;255. 0.00 5 MAT` Miscellaneous'items 36:555.23.5 0.005 0.00 5 32 899:70;5" 32'899.70:5 3'655.525 3289.97-5 LAB •Auditorium .3.504.20$ - 0.00;5 0.00$ 0:00$ .0,00'5 3.504.20$ '0.00.$ 1:08. 4East 5'910,02$ 0.00,$ 0.00.5 0.00'.5 0:005 5.910.02.$ 0.00 5 LAB , North-' :95.38.$ 000.5 0.00$ 0.00!5 o,00`,5 95.38 S 0.00'$ LAB -South. 39'165.15 5 0:00 5 0.005 0.005 0.00'$ 39 165.15$ 0.005 . LAB West 3:896.68 5 0.00'$ 0,00;5 0:00'5 0:00'5 3 896.60$ 0.005 LAB. Miscellaneous items- 53:195.105, 0,005 000.5 0.00$ 0,005 53 195.10 5 0:00$ MAT " ALLOWANCE 105'000.00!$ 0:00•-$ 0.00;$ 0.00$ 0:00$ 105 000.00$ 0.00.$ .P60c 5 CONTINUATlON,SHEET AlA•DocimmntG703 Format AMA Dec.0762;APPLICATION AND CERTIFICATE FOR PAYMENT containing Contractor's signed Certiticatfon,ls attached. COatractont taric:Deau{iols 4tec Inlabulallons below,;anmunts are mated toll a hearc'stdollar. APPLICATION ION DA 0:;.13 Use Column Ion Contracts where variable.retalna a for line'items ma s I APPLICATION OATE:.0 2 2 010. 8 Y"�PP Y•• APLICATION PERIOD,:02/01/2010.-02/284010 ARCHITECT'S PROJECT.NO:, Cannel ResIonal Performing.Arts Center,TCarmet,IN A B C; .D E F G. H Work Completed` Material Total Item. Description Scheduled Previous This 'Present) Value application Period Y Complete '%. Balance Retal%' No. of`work. Stored :and stored (D+E). to Finish 10%' (not In 0 or El .(0'«E.+F.) (G'./;.C)' (C.G) 5060,General Allowance 50 000.00 S 0.005 5060 CAD Allowance. 0:00,$ 03; '.50000:00;5 0.00.5 5 OOO,OOS 0:00:5 000': 5 0% 5 000:00.5, 5070 General Allowance 25;000,005 0.00'5 0.00',5 '0:00.5...., OS 25:00.005 .000:5. 5070 CAD Allowance 5-000,00'$ 0.00.$ '0;00'5 - ,05 5000.00,51 :0.005 5080 General Allowance 15 000:00 S 0.00.$' .5000 CAD Allowance 0.00,5 0% :1S0000.S 0.00.5 5 000.00$ 0.00,5 0.00 5 OS 5 000:00.5 0.00.5 SUBTOTAL '2 619 462122.5 4 423:24$ 0.00:5 321 924.05,5 326,347.29'5 3.293 114.93 5' 32.634:73.$ Adrn(nIstratlon Fees' MAT Shop Drawings 179 383.84 S 174x383.84 5 0.00 5 INST 974'383:84;5 100% 0.00 5 17 438.38 5 MAT Engeneor ng and cuttingshoot 9.16 255:86.5 49 990:025 2'325:123 INST 52 315.14,5 45% 63..940:725 5231.515 MAT Bond. 20.325:26:5 20'325:26$ •0:00 S' !HST 20325.26 5 100% .0:00;5' 4;032.535 MAT Projet Management TLiving/Travel 125 378:55'$ INST 58927:925 3.761:36'8- 62 689.20 5 50% 62.689:28.$ 6468,975 'MAT. Superintendent I Living I Travel 118'264'.275 29:566.07,.5 5'913.21'5 11JST 35 479.20 5 30% 82 784:99 S 3 547:93 5 TOTAL BASE CONTRACT 3 174 070.00$ 337 616.35 $ 11'999.69$ 329 924.05$ 671 540:08'$ 2,502-529.92$ 6T154:01$ Cfianpe.Ordors MAT Change order d0015: '5.150.00 . 'KIST Change ardr800 S 0.00'5 - 0:00.5 0% .5'-156.00.5 MAT ' .17 .0.00!$ - 0.005 • 0.00 5 0% 17479.005 O.OD$ dNST • TOTAL CHANGE ORDERS 5: 22-.635.00 5 7 '.61 .22835:00: S I TOTAL 1 Is 3.196.705.00 I S '337 616.35.:5 i-+•rte-.i'i 11'.999.69 I:5, 321 924.05 1 :.67.1;640:08 I rym 2.525 184.82'.1 5 67 154-01 ... rr Calcole«M:.IVi« tF.1?:. ill Page:0 WAIVER OF LIEN The undersigned is the duly authorized officer of_Ebenisterie Beaubois Ltee , the general contractor, subcontractor, materialman or other person furnishing the services, labor, material or equipment indicated below in the construction of improvements upon real estate located in_Hamilton County, State of_Indiana ,commonly known as_Carmel Performing Arts Center ,which real estate is owned by_Carmel Redevelopment Commission @Owner»). IN CONSIDERATION of the sum of Thirteen thousand eight hundred fourty eight dollars_and twenty six cents DOLLARS ($_13,848.26) receipt of which is hereby acknowledged,and in order to procure one or more payments for services, labor, material or equipment provided in such construction, the Company does hereby waive, release and quit claim in favor of the Owner of the real estate and the lender or lenders providing funds with which payment of construction costs is or is to be made, and their assigns, all liens or claim or right to liens upon the land or improvements above described which the Company may now have for services, labor, material or equipment furnished in respect of such land or improvements to and including the date hereof. The undersigned warrants that the Company has not and will not assign any claim for payment nor any right to perfect a lien against the real estate, and that he has the right to execute this waiver and release of liens on behalf of himself(herself) and the Company. The undersigned further warrants and represents that the Company has the right to transfer and does hereby transfer title to the services, labor, material or equipment to the Owners or Lenders named above in consideration of the payment received hereunder. The undersigned further states that the consideration received hereunder is the sole consideration received by the Company for said services, labor, material or equipment furnished to date, and that the Company has neither received nor made any security interest, title retention interest or lien rights in the said services, labor,material or equipment other than that released and transferred hereby. The material, labor, services or equipment furnished are more particulary described in the affidavit for payment submitted of even date herewith. The undersigned further warrants and represents that the Company has complied with all prevailing wage requirements under applicable law or as may be set forth in the contract documents. WITNESS the execution hereof this_2nd day of_Febru.II. ,_2010 c,—,..—.„az., main Alexandre,Ass.General Manager _Ebenisterie Beaubois Ltee (Name of Company) State of_Quebec , County of_Beauce , SS : Before me, the undersigned, a Notary Public in and for said County and State,personally appeared_Germain Alexandre The _Assistant General Manager , of _Ebenisterie Beaubois Ltee , who acknowledged.the execution of the foregoing Waiver of Lien on behalf of such Company and that the same is the free act deed of such Company and the free act and deed of said officer. WITNESS my hand and notarial seal this_2nd day of_February_, 2010 My Commission Expires : ,� Commissaire a I'Assermenfafion ,- ./ _May 10,2010 / /,V7Z•/ !�(�2 Commissioner for oath Manon Poulin Notary Public My County of Residence: # 103 850 Beauce District Beauce-Quebec Manon Poulin Beauce-Quebec District (Printed Name of Notary Public) ..ill 3E-A- EAUBOIS BILL OF SALE CARMEL PERFORMING ARTS CENTER FOR GOOD CONSIDERATION, and upon payment of Three hundred twenty one thousand nine hundred twenty four 05/100 dollars ($321,924.05) and to extent as billed on Pay Request 13 the undersigned, Ebenisterie Beaubois Ltd., 521, 6th Avenue, Saint-Georges Quebec, G5Y OH 1 (fl Seller ») hereby sells and transfers to Shiel Sexton Inc (■■ Buyer »), the following : See breakdown attached Which are stored at : Ebenisterie Beaubois Lee, 511, 6th Avenue, Saint-Georges Quebec, G5Y OH1 (418)228-5104 (418)228-3524 fax The seller warrants it has a good title to said property, full authority to sell and transfer same, and that said property is sold free of all liens, claims and encumbrances. Signed under seal this 15u1 day of February 2010 e-nisterie Beaubois Ltee Ge ain Alexandre, Assistant General Manager � Commissaire I'Assermentatidn /%ll/l%?� ,j C, � Ccri:niteioner for J.,.,:.:11 Notary Public Manon Poulin It 163 850 District Beauce-Quebec Beauce-Quebec District r ,7,7T(-7,47L.7--.zW7 REF. N° 09-F007 - OERIFIFICATE 4111PINSUR:ANCE I Aon Reed Stenhouse Re: Project 5037:Carmel Performing Art Center 700,De La Gauchetlere Street West Suite 1800 Period from February 01,2010 to February 28,2010 Montreal,Quebec H3B 0A4 514-842-5000 fax.:514-842-3456 Stored Material at 511,6th Avenue,St-Georges,Quebec • Certificate Holder • Shiel Sexton • 902 N.Capitol Avenue Indianapolis,IN 46204 Insurance as described herein has been arranged on behalf of the Insured named herein under the following policy(is)and as more fully described by the terms, conditions;exclusions and provisions contained in the said policy(ies)and any endorsements'attached thereto. Insured • E.BE.NISTERIE BEAUBOIS LTD • 521,6TH AVENUE ST-GEORGES (QUEBEC). G5Y OH1 Coverage General Liability Insurer: Chartis Insurance company of Canada - --- - --- • -••.-.......-... .• - • -- . . •-- ... .-.. - .....•-- -• -....- •--•-- - • - • Policy 6645-7761 Effective: December 01,20.9.s Expiry.; December,01,_2010 _Perlis Insured: • _ .. .. gc90990. ductsid 913eratio95a.1101Nale $2,000,000 Non-Owned Automobile Liability $2,000,000 Property insurance 1.nstqqr . _. . AffirlatecIFM.lnsur9119e...POPP9Y. _ 1.31'1:437. Effective: - December 01,2000 Expiry: December 01,2010 ••••••. ....... „ Perils insured: All Risks including flood and earthquake Limits _ . All Risks including flood andeaithquake . . . $321,924.05 USD ..... ... . .. . .. Additional Insured Shiel Sexton and Cannel Redevelopment Cofnmissidn(as the owner)are add as additional insured,but solely regarding the liability arising out of the Insured's operations with respect to the above project. THIS CERTIFICATE OF INSURANCE CONSTITUTES A STATEMENT OF THE FACTS AS OF THE DATE OF ISSUANCE AND ARE SO REPRESENTED AND WARRANTED ONLY TO THE INSURED. OTHER PERSONS RELYING ON THIS CERTIFICATE DO-SO AT THEIR OWN RISK. Mn Reed Stenhouse Inc. Date: February 15,zoio Issued by Marie-)oseeplarchand,CIP akk,:iq A 104.3, Tel 514-840-7715 Sign ture • THIS POLICY CONTAINS A.CLAUSE THAT MAY LIMIT THE AMOUNT PAYABLE 1 OR IN THE CASE OF AUTOMOBILE INSURANCE, THE POLICY CONTAINS A PARTIAL PAYMENT OF LOSS CLAUSE