HomeMy WebLinkAboutPoynter Sheet Metal - $888,060 Disbursement Instructions
(PAC Air Handler Equipment)
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
(ciri'r c4 � � lnenirs it reViait514 m61e 11
C ttj r&A 1e t`y h,,r k" 4 E• 1,v C R ut Ri't'
-\lskr\SFerre;) io vdiMe f-ir,m1(t∎\} Ll-C
Total Authorized Disbursement
All terms used in these Disbursement Instructions without definition shall have the meanings ascribed thereto
in that certain Loan Agreement (PAC Air Handler Equipment), dated January 28, 2010, by and between
Lender and Village Financial, LLC.
Dated: !' a_— CITY OF CARMEL REDEVELOPMENT
CO i 1 ISSION
By V41
Printed L it S. 04-0-r
Title ti>at '74-'0 /2/feC7o4
'S
Draft
PAC Air Handling Equipment
(Poynter)
Up Through November 2009
IPC Amounts through application 16
Completed and Stored to date $ 934,800.00
Retention held (based on 5% retention) $ 46,740.00
Paid to date $ 888,060.00
New Amount Requested $ 888,060.00
December 2009
IPC Amount for application 17
Completed and Stored $ -
Retention held (based on 5% retention) $ -
To be paid $ -
New Amount Requested $ -
Overall Amount Requested $ 888,060.00
Draft
PAC Air Handling Equipment
11/30/09
Contractor Equipment Contract Total Completed to Date Remaining Balance
Poynter Air Handler $ 550,000.00 $ 550,000.00 $ -
Louvers $ 27,000.00 $ 27,000.00 $ -
Grilles/Register/Diffusers $ 62,200.00 $ - $ 62,200.00
Fire Dampers $ 23,200.00 $ 23,200.00 $ -
Volume Dampers $ 6,600.00 $ 6,600.00 $ -
Sound Attenuators $ 66,000.00 $ 66,000.00 $ -
Fans $ 192,000.00 $ 192,000.00 $ -
Chimney Fans $ 8,000.00 $ - $ 8,000.00
VAV Boxes $ 70,000.00 $ 70,000.00 $ -
Total $ 1,005,000.00 $ 934,800.00 $ 70,200.00
Amount Completed $ 934,800.00
- CONTINUATION SHEET Page 3 of
Application and Certification for Payment,containing Application No. : 16
Contractor's signed certification is attached. Application Date: 11/11/2009
In tabulations below,amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply. To 11/30/2009
Architect's Project No.: 2695-4310
Invoice#: 14065-16 Contract: 14065-CARMEL PERFORMING ARTS CENTER
A- --- li C n F - - F G -..i H ._._._.
Item Description of Work Scheduled Work Completed Materials Total % Balance Retainage
No. Value From Previous This Period Presently Completed (G/C) To Finish
Application In Place Stored and Stored (C-G)
(D+E) To Date
(Not in D or E) (D+E+F)
34 MATERIAL 77,000.00 61,600.00 0.00 0.00 61,600.00 80.00% 15,400.00
35 LABOR 93,900.00 75,120.00 0.00 0.00 75,120.00 . 80.00% 18,780.00
36 INSULATION 16,800.00 0.00 0.00 0.00 0.00 0.00% 16,800.00
37 MECH RM 3 0.00 0.00 0.00 0.00 0.00 0.00% 0.00
38 MATERIAL 84,900.00 76,410.00 0.00 0.00 76,410.00 90.00% 8,490.00
39 LABOR 94,500.00 75,600.00 0.00 0.00. 75,600.00 80.00% 18,900.00
40 INSULATION 16,800.00 0.00. 0.00 0.00. 0.00 0.00% 16,800.00
41 PLENUM LEVEL 0.00 0.00' 0.00 0.00 0.00. 0.00% 0.00
42 MATERIAL 49,100.00 46,645.00 0.00 0.00 46,645.00 95.00% 2,455.00
43 LABOR 75,000.00 67,500.00 3,750.00 0.00 71,250.00 ' 95.00% 3,750.00
44 LAGGING 13,000.00 0.00 0.00 0.00 0.00 0.00% 13,000.00
45 ORCHESTRA HIGH LEVEL 0.00 0.00 0.00 0.00 0.00 0.00% 0.00
46 MATERIAL 34,600.00 20,760.00 3,460.00 0.00 24,220.00 70.00% 10,380.00
47 LABOR 35,400.00. 14,160.00 3,540.00 0.00 17,700.00 50.00% 17,700.00
48 ORCHESTRA LOW LEVEL 0.00, 0.00 0.00 0.00 0.00' 0.00% 0.00
49 MATERIAL 49,400.00 29,640.00 2,470.00 0.00 32,110.00 65.00% 17,290.00
50 LABOR 62,600.00. 25,040.00 3,130.00 0.00 28,170.00 45.00% 34,430.00
51 BOX TIER LEVEL 0.00 0.00 0.00 0.00- 0.00 0.00% 0.00
52 MATERIAL 70,000.00 28,000.00 7,000.00 0.00 35,000.00 : 50.00% . 35,000.00
53 LABOR 100,300.00 30,090.00 10,030.00 0.00 40,120.00 40.00% 60,180.00
54 LOW BALCONY LEVEL 0.00 0.00 0.00 0.00' 0.00 0.00% 0.00
55 MATERIAL 94,100.00 9,410.00 18,820.00 0.00 28,230.00 30.00% 65,870.00
56 LABOR 85,300.00' 6,824.00 10,236.00 0.00' 17,060.00 20.00% 68,240.00
57 HIGH BALCONY LEVEL 0.00 0.00 0.00 0.00 0.00 0.00% 0.00
58 MATERIAL 38,400.00. 3,840.00 7,680.00 0.00 11,520.00 30.00% 26,880.00
59 LABOR 50,200.00 4,016.00 1,004.00 0.00 5,020.00 10.00% 45,180.00
60 ATTIC LEVEL+50 0.00 0.00 0.00 0.00 0.00 0.00% 0.00
61 MATERIAL 41,600.00 10,400.00 0.00 0.00 10,400.00 25.00% 31,200.00
62 LABOR 44,700.00 11,175.00 0.00 0.00 11,175.00 25.00% 33,525.00
63 ATTIC LEVEL +61 0.00' 0.00 0.00 0.00 0.00 0.00% 0.00
64 MATERIAL 16,800.00 8,400.00 0.00 0.00 8,400.00 ' 50.00% 8,400.00
65 LABOR 16,300.00 8,150.00 0.00 0.00 8,150.00 50.00% 8,150.00
CONTINUATION SHEET Page4of4
Application and Certification for Payment,containing Application No. : 16
Contractor's signed certification is attached. Application Date: 11/11/2009
In tabulations below,amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply. To: 11/30/2009
Architect's Project No.: 2695-4310
Invoice#: 14065-16 Contract: 14065-CARMEL PERFORMING ARTS CENTER
Item Description of Work Scheduled Work Completed Materials Total % Balance Retainage
No. Value From Previous This Period Presently Completed (G/C) To Finish ■
Application In Place Stored and Stored (C-G)
(D+E) To Date
(Not in D or E) (D+E+F)
66 ATTIC LEVEL+66 0.00 0.00 0.00 0.00 0.00 0.00% 0.00
67 MATERIAL 39,500.00 9,875.00 0.00 0.00. 9,875.00 25.00% . 29,625.00
68 LABOR 37,900.00 9,475.00 0.00 0.00 9,475.00 25.00% 28,425.00
69 ATTIC LEVEL+79-6 0.00 0.00 0.00 0.00 0.00 0.00% 0.00
70 MATERIAL 6,700.00 6,030.00 0.00 0.00 6,030.00 90.00% 670.00
71 LABOR 5,200.00 3,640.00 780.00 . 0.00 4,420.00 85.00% . 780.00.
4-A ALLOWANCE NO. 11 BP 4310(ASI-0< 7,322.00 7,322.00. 0.00 0.00. 7,322.00 100.00% 0.00
4-B ALLOWANCE NO 11 BP 4310A-002 10,000.00 7,500.00' 2,500.00 0.00 10,000.00 100.00% 0.00
4-C ALLOWANCE NO 11 BP 4310B-002 4,798.00 3,359.00: 1,439.00 0.00. 4,798.00 , 100.00% 0.00
4-D ALLOWANCE NO 11 BP 4310B-003 27,476.00 21,981.00 5,495.00 0.00. 27,476.00 100.00% 0.00
4-E ALLOWANCE NO 11 BP 4310B-004 1,534.00 1,534.00 0.00 0.00 1,534.00 100.00% 0.00
900 PENDING CHANGE ORDERS 0.00 0.00 0.00 0.00. 0.00 0.00% 0.00
901 CHANGE ORDER#1 38,542.00 21,198.00 0.00 0.00 21,198.00 55.00% 17,344.00
902 CHANGE ORDER#2 (RCP-10) 19,219.00 15,375.00 0.00 0.00 15,375.00 80.00% 3,844.00
- • �,i- Grand Totals 3,403,261.00 2,180,309.00 111,949.00 0.00 2,292,258.00 67.35% 1,111,003.00 170,163.05
• AFVLICA 1 ION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER-ADVISER EDITION 6%J ��Q
' IA DOCUMENT G702/CMa PAGE ONE OF 4 PAGES
TO OWNER: PROJECT: Parcel 7A, Regional Performing APPLICATION NO: 16 Distribution to:
Carmel Redevelopment.Commission Arts Center [OWNER
One Civic Square PERIOD TO: 11/30/09 [CONSTRUCTION
Carmel, IN 46032 PROJECT NO: 2695-4310 MANAGER
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: Shiel-Sexton Co., Inc. (PSM#14065) [ARCHITECT
POYNTER SHEET METAL ATTN: Lynda Weaver, 902 N. Capitol Avenue, Indianapolis, IN 46204 CONTRACT DATE: 04/18/08 [CONTRACTOR
8768 N. STATE RD. 37 VIA ARCHITECT:
BLOOMINGTON,IN 47404
CONTRACT FOR: Bid Package#4310-HVAC Sheet Metal
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet,A1A Document G703,is attached. completed in accordance with the 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,and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM $ 3,345,500.00
2. Net change by Change Orders $ 57,761.00 CONTRACTOR:
3. CONTRACT SUM TO DATE(Line 1 ±2) $ 3,403,261.00
4. TOTAL COMPLETED&STORED TO DATE $ 2,292,258.00 41P4 A
(Column G on G703) By: " ' -. Date: /1/ 3/0
5. RETAINAGE: 5%of Contract Total Joseph R. 'ansde 1' •-nt
a. 5 %of Co upleted Wore,
r�•��-•� $ 170,163.05 State of I •NA County of: MONROE/,,�,� h7•(Column D+Eon G703) Subscribed ands o ►- ore htis `C� day of A/0V/nbe acv/
b. 10 %of Stored Material $ 0.00 Notary Public: fa /�
(Column F on G703) My Commission expires: \August 29,2014
Total Retainage(Lines 5a+5b or
Total in Column 1 of G703) $ 170,163.05 R • - • ' ' 1 1
6. TOTAL EARNED LESS RETAINAGE 2,122,094.95 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Line 5.total) S comprising this application,the Construction Manager and Architect certify to the
7. LESS PREVIOUS CERTIFICATES FOR Owner that to the best of their knowledge,information and belief the Work has
PAYMENT(Line 6 from prior Certificate) $ 2,010,145.95 progressed as indicated,the quality of the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE $ 111,949.00 Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 1,281,166.05 1 1 1���r0-.)
(Line 3 less Line 6) AMOUNT CERTIFIED $ "
CHANUL ORDER SUMMARY ADM I IONS DLDUC I IONS (Attach explanation if amount certified differs from the amount applied for. Initial all
I otal changes approved figures on this Application and on the Contin • Sheet that changed to conform to the
in previous months by Owner $57,761.00 amount certified.la /
CO TRUCT I 1 ;�,: •4 ER: / Z� O`
Total approved this Month $0.00 By: �r
y� �i %,,r��� � e Date:
TOTALS $57,761.00 $0.00 By: � ° p ' - -°. —.... `l -3 I - �/
Y i ..._- Date:
NET CHANGES by Change Order $57,761.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein.Issuance,payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
THE AMERICAN INSTITUTE OF ARCHITECTS,1745 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006-5292
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
CONTINUATION SHEET Page2of4
Application and Certification for Payment,containing Application No. : 16
Contractor's signed certification is attached. Application Date: 11/11/2009
In tabulations below,amounts are stated to the nearest.dollar.
Use Column I on Contracts where variable retainage for line items may apply. To 11/30/2009
Architect's Project No.: 2695-4310
Invoice#: 14065-16 Contract: 14065-CARMEL PERFORMING ARTS CENTER
------A --- ____ - - _B --- -_ --- __ :___---. C-- - --- - E -------- F-
G - - H
Item Description of Work Scheduled Work Cnmpleted Materials Total % Balance Retainage
No. Value From Previous This Period Presently Completed (G/C) To Finish
Application In Place Stored and Stored (C-G)
(D+E) To Date
(Not in D or E) (D+E+F)
1 GENERAL CONDITIONS 200,000.00 132,000.00, 16,000.00 0.00 148,000.00 74.00% 52,000.00
2 BOND & INSURANCE 45,000.00. 45,000.00. 0.00 0.00 45,000.00. 100.00% 0.00
3 MOBILIZATION 15,000.00 15,000.00 0.00 0.00 15,000.00 100.00% 0.00
4 ALLOWANCE NO 11 BP 4310 208,870.00 0.00 0.00 0.00 0.00 0.00% 208,870.00
5 ALLOWANCE NO 16 CAD AS-BUILT 10,000.00 0.00 0.00 0.00 0.00 0.00% 10,000.00
6 DRAWINGS/COORDINATION 80,000.00. 80,000.00 0.00 0.00: 80,000.00 . 100.00% 0.00.
8 EQUIPMENT 0.00 0.00 0.00 ' 0.00' 0.00 0.00% 0.00
9 AIR HANDLERS 550.000.01 550,000.00 0.00 0.00 550,000.00' 100.00% 0.00
10 LOUVERS 27,01. !HI 27,000.00 0.00 . 0.00 27,000.00 100.00% 0.00
11 r GRILLES/REGISTERS/DIFFUSERS! .2,200 1: 0.00 0.00 0.00 0.00 0.00% 62,200.00'
12 t FIRE DAMPERS 23,200.1! 23,200.00' 0.00 0.00. 23,200.00 100.00% 0.00
13 VOLUME DAMPERS 6,600.:1 6,600.00 0.00 0.00. 6,600.00 100.00% 0.00
14 SOUND ATTENUATORS 66,000.11 66,000.00 0.00 0.00 66,000.00 100.00% 0.00
15 FANS 192 000.0. 192,000.00 0.00 0.00 192,000.00 100.00% 0.00
16 CHIMNEY FANS 8,111.01 0.00 0.00 0.00! 0.00 0.00% 8,000.00
17 VAV BOXES 70,t,1.00 70,000.00 0.00 0.00: 70,000.00 100.00% 0.00
18 MECH BASEMENT LEVEL 1.00 0.00 0.00 0.00 0.00 0.00% 0.00
19 MATERIAL 48,000.00 45,600.00 0.00 0.00 45,600.00 95.00% 2,400.00
20 LABOR 50,700.00 48,165.00. 0.00 0.00 48,165.00 95.00% . 2,535.00
21 LAGGING 7,000.00 0.00 0.00 0.00 0.00 0.00% ' 7,000.00
22 BACKHOUSE 0.00 0.00 0.00 0.00 0.00 0.00% 0.00
23 MATERIAL 56,000.00 39,200.00 0.00 . 0.00 39,200.00 . 70.00% 16,800.00
24 LABOR 59,000.00 29,500.00 11,800.00 0.00. 41,300.00 70.00% 17,700.00
25 KITCHEN HOOD& DUCT 0.00 0.00 0.00 0.00 0.00 0.00% 0.00
26 MATERIAL 15,400.00 2,310.00 0.00 0.00 2,310.00 15.00% 13,090.00
27 LABOR 10,800.00 1,080.00 0.00 0.00 1,080.00 10.00% 9,720.00
28 INSULATION 10,100.00 0.00 0.00 0.00, 0.00 0.00% 10,100.00
29 MECH RM 1 0.00 0.00 0.00 0.00 0.00 0.00% 0.00
30 MATERIAL 50,400.00 45,360.00 0.00 0.00 45,360.00 90.00% 5,040.00
31 LABOR 56,300.00 42,225.00 2,815.00 0.00 45,040.00 80.00% 11,260.00
32 INSULATION 16,800.00 0.00 0.00 0.00 0.00 0.00% 16,800.00
33 MECH RM 2 0.00 0.00 0.00 0.00. 0.00 0.00% 0.00
r+r r I-1v,.6 ivili fr IV v %.CR 111'mil-% I C rurc FA T IVItIY I CONSTRUCTION MANAGER-ADVISER EDITION
AIA DOCUMENT G702/CMa PAGE ONE OF 4 PAGES
TO OWNER: PROJECT: Parcel 7A, Regional Performing APPLICATION NO: 15 Distribution to:
Cannel Redevelopment Commission Arts Center nOWNER
One Civic Square PERIOD TO: 10/31/09 DCONSTRUCTION
Carmel, IN 46032 PROJECT NO: 2695-4310 MANAGER
. FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: Shiel-Sexton Co., Inc.'. (PSM#14065) nARCHITECT
POYNTER SI-IEET METAL ATTN: Lynda Weaver,902 N. Capitol Avenue, Indianapolis;-IN 462b4 CONTRACT DATE: 04/18/08 nCONTRACTOR
8768 N. STATE RD. 37 VIA ARCHITECT: ,
BLOOMINGTON,IN 47404 i
CONTRACT FOR: Bid Package#4310-HVAC Sheet Metal �`` '54 51/
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment,as shown below,in connection with the Contract. information and belief'the Work covered by this Application for Payment has been
Continuation Sheet,AIA Document G703,is attached. completed in accordance with the 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,and that current payment shown herein is now due.
I. ORIGINAL CONTRACT SUM $ 3,345,500.00
2. Net change by Change Orders $ 57,761.00 CONTRACTOR:
3. CONTRACT SUM TO DATE(Line I f 2) $ 3,403,261.00 �+
4. TOTAL COMPLETED&STORED TO DATE $ 2,180,309.00 ^: (if
(Column G on G703) C /0//9 jOF
By:B Date:
5. RETAINAGE: 5%of Contract Total Joseph R.1 ansdiel'resid: t
a. 5 %of Comply $ 170,163.05 State of: [ND
(Column D+E on G703) /i Cy nty D t___ a�OQ
Subscribed and sworn to before th's �CJC/ /
b. 10 %of Stored Material $ 0.00 Notary Public:442' ;w day of
(Column F on G703) My Commissio? expires: August 9,2014 /
Total Retainage(Lines 5a+5b or
Total in Column I of G703) $ 170,163.05 CERTIFICATE FOR PAYMENT
6. TOTAL EARNED LESS RETAINAGE 2,010,145.95 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Line 5 Total) $ comprising this application,the Construction Manager and Architect certify to the
7. LESS PREVIOUS CERTIFICATES FOR Owner that to the best of their knowledge,information and belief the Work has
PAYMENT(Line 6 from prior Certificate) $ 1,799,275.95 progressed as indicated,the quality of the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE $ 210,870.00 Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 1,393,115.05 /�
(Line 3 less Line 6) AMOUNT CERTIFIED U $ Zl ���w el
CHANGE UKEK SUMMA Y AUDI I IONS UEDUC I IONS ' (Attach explanation ifamount certified differs from the amount applied for. Initial all
'1 otal changes approved figures on this Application and on th- Contin . ion Sheet that changed to conform to the
in previous months by Owner $57,761.00 amount certified
CO TRUCTI IF u1V.•• ER: /
Total approved this Month $0.00 By: '►i1/!,: j� � .�� Date: /0 ' Dg
AR
TOTALS $57,761.00 $0.00 By:---17-1,36*-
{t 1,j j_,_ - Date: t • 2"
NET CHANGES by Change Order $57,761.00 This Certi Irate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein.Issuance,payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
AIA DOL•MEN t,702lCMa• •'FL L.AI UN AN•LERTIFT ' •1 OR PAYMENT. ••S -IL • ,•,• EA-•"•y -El •N 1992 ED UN AEA•U '92 WO2/UMa-1991
THE AMERICAN INSTITUTE OF ARCHITECTS,1745 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006-5292
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
•
APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER-ADVISER EDITION
AIA DOCUMENT G702/CMa PAGE ONE OF 4 PAGES
,
TO OWNER: PROJECT: Parcel 7A, Regional Performing APPLICATION NO: 14 Distribution to:
Carmel Redevelopment Commission Arts Center nOWNER
One Civic Square PERIOD TO: 9/30/09 nCONSTRUCTION
Carmel, IN 46032 - ---,-__. 7.9__ROJECT NO: 2695-4310 MANAGER
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: Shiel- idakc;_s5 o: 1 .I it . ? 1l (PSM#14065) [TARCHITECT
POYNTER SHEET METAL ATTN: Lynda Weaver,902 N. Capitol Avenue, Indiana b�(s, IN 46204 CON iZACT DATE: 04/18/08 nCONTRACTOR
8768 N. STATE_. RD. 37 VIA ARCHITECT: SEP �i 2009 j 11)1
ul 2 - u
BLOOMINGTON,IN 47404 �,�
CONTRACT FOR: Bid Package#4310-HVAC Sheet Metal f:::1; 9
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigns on r tut(c�ii 't to the best of the Contractor's knowledge,
Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet,AIA Document G703,is attached. completed in accordance with the 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,and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM $ 3,345,500.00
2. Net change by Change Orders $ 5 ,761.00 CONTRACTOR:
3. CONTRACT SUM TO DATE(Line 1 ±2) $ 3,403,261.00
4. TOTAL COMPLETED&STORED TO DATE $ 1,969,439.00 'i f•
I
(Column G on G703) By: Date: o9/2/
5. RETAINAGE: 5%of Contract Total Joseph R.L:nsdel 0 esiden
a. 5 %of Cer+tpleted-Welk 5 170,163.05 State of INDIA County� MONROE
o umn D+E on G703) Subscribed and s o to before me thi • a_1 day of .m
b. 10 %of Stored Material $ 0.00 Notary Public: '�"'"'
o umn F on G703) My Commissio expires: August 29,2014
Total Retainage(Lines 5a+5b or •
Total in Column I ofG703) $ 170,16/.05 CER IFICATE FOR PAY1VIEN
6. TOTAL EARNED LESS RETAINAGE 1,799,275.95 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Line 5 Total) $ comprising this application,the Construction Manager and Architect certity to the
7. LESS PREVIOUS CERTIFICATES FOR Owner that to the best of their knowledge,information and belief the Work has
PAYMENT(Line 6 from prior Certificate) $ 1,627,213.95 progressed as indicated,the quality of the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE $ 172,062.00 Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 1,603,985.05 �00
(Line 3 less Line 6) $ �.
AMOUNT CERTIFIED
CHANGE ORDER S MARY AUDI 1 IONS DEDUC NUNS (Attach explanation if amount certified differs from -amount applied for. Initial all
"I otal changes approved figures on this Application and on the Continuati' eet that changed to conform to the
in previous months by Owner $57,761.00 amount certifie•a •
CO.;STRU y'1.j��','i AGER:
Total approved this Month $0.00 AR.�! C► 1.��:��4La • / Date: Q �`T
TOTALS $57,761.00 $0.00 By: pIri�� 1 Date: ri • •0
NET CHANGES by Change Order $57,761.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance,payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
AIA UO(. ' NIG/OZ/(.Ma .I-'LI(,A •, •'1(,ERI IFIeATION I-•"•'M NT•(,•`S '•L •' '.'.uE-•A•' - • ON 99ZEDII ION•AIA C11992 (, 02K,Ma-1992
THE AMERICAN INSTITUTE OF ARCHITECTS,1745 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006-5292
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
I1 f- ?- LI JI- II !Will MITI J arcl'% r IrIVM 1 C rjrt r bk II IYICIV I CONSTRUCTION MANAGER-ADVISER EDITION
AIA DOCUMENT G702/CMa PAGE ONE OF 4 PAGES
TO OWNER: PROJECT: Parcel 7A, Regional Performing APPLICATION NO: 13 Distribution to:
Carmel Redevelopment Commission Arts Center nOWNER
One Civic Square PERIOD TO: 8/31/09 nCONSTRUCTION
Carmel, IN 46032 PROJECT NO: 2695-4310 MANAGER -. ''
' N.,
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: Shiel-Sexton Co., Inc. (PSM#14065) nARCI-IITECT'`
POYNTER SFIEET METAL ATTN: Lynda Weaver,902 N. Capitol Avenue.Indianapolis,IN 46204 CONTRACT DATE: 04/18/08 nCONTRACTOR:
8768 N. STATE RD. 37 VIA ARCHITECT: -
BLOOMINGTON, IN 47404 `.;`
V CONTRACT FOR: Bid Package#4310- HVAC Sheet Metal - ! `� CAN r'
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowlettg Q' ==
Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been'.,.;' \\ ,)'
Continuation Sheet,ALA Document G703,is attached. completed in accordance with the 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,and that current payment shown herein is now due. N:''.):',/
I. ORIGINAL CONTRACT SUM $ 3,345,500.00
2. Net change by Change Orders $ 57,761.00- CONTRACTOR:
3. CONTRACT SUM TO DATE(Line 1 ±2) $ 3,403,261.00
4. TOTAL COMPLETED&STORED TO DATE $ 1,797,377.00 44 dr;(Column G on G703) By: �. . ;�.
w Date: oepVQ
5. RETAINAGE: 5%of Contract Total Joseph R.L.nsdell Reside
a. 5 %of�k 5 170,163.05 State of INDIA∎A County of MONROE=Li(Column D+Eon G703) Subscribed and sworn to be ore e this /,�.�8w-- day of A Lt US7- c OO9
b. 10 %of Stored Material $ 0.00 Notary Public: ,z , ��t� � Sv /
(Column F on G703) - My Commission expires: August 2i) 2014
Total Retainage(Lines 5a+5b or
Total in Column I of 0703) $ 170,163.05 CERTIFICATE FOR PAYMENT
6. TOTAL EARNED LESS RETAINAGE 1,627,213.95 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Line 5 Total) $ comprising this application,the Construction Manager and Architect certify to the
7. LESS PREVIOUS CERTIFICATES FOR Owner that to the best of their knowledge, information and belief the Work has
PAYMENT(Line 6 from prior Certificate) $ 1,587,210.90 progressed as indicated,the quality of the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE $ 40,003.05 Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED. 05
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 1,776,047.05 $ 4 ��� •
(Line 3 less Line 6) AMOUNT CERTIFIED
CHANGE,ORDLR SUMMARY AUDI I IONS OLDUC l IONS ' (Attach explanation if.amount certified differs fro -r amount applielfbr. Initial all
1 otal changes approved figures on this Application and on the Continu ion Sh t that changed to conform to the
in previous months by Owner $38,542.00 amount certified,
CO TRUCTIj i �� ER:
Total approved this Month $19,219.00 By: �,,,i '!"........44,46., /, Date: . Z` .."
AR 'ITE hi.
TOTALS $57,761.00 $0.00 By �. /'. Date " S :•/, if
NET CHANGES by Change Order $57,761.00 This Certifi ate •gotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein.Issuance,payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
AIR DOCUMENT G U (-Ma•API'LICA ION NU CERTIFICATION FO '•'■ N .LII'S 'I(, • ■•'• R ITV S R tU ITON- 992 Ell IN.AIA•(01992 G 0 CMa-1992
THE AMERICAN INSTITUTE OF ARCHITECTS,1745 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006-5292
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
•
.-.• . --.• vL..ix i u wr%I I—. rvr1. rrt, t iriLw i CONSTRUCTION MANAGER-ADVISER EDITION
AIA DOCUMENT 6702/CMa PAGE ONE OF 4 PAGES
TO OWNER: PROJECT: Parcel 7A, Regional Performing APPLICATION NO: 12 Distribution to
Cannel Redevelopment.Commission Arts Center [OWNER
One Civic Square PERIOD TO 6/30/09 CONSTRUCTION
Carmel, IN 46032 PROJECT NO 2695-4310 MANAGER
FROM CONTRACTOR: (2iNSTRUCTION MANAGER: Shiel-Sexton Co., Inc. (PSM#14065) ARCHITECT
POYNTER SHEET METAL A N Lynda , °.v`,. 902 N. Capitol Avenue, Indianapolis, IN 46204 CONTRACT DATE: 04/18/08 [CONTRACTOR
8768 N. STATE RD. 37 ARCHI ' -CT:
BLOOMINGTON,IN 47404
CONTRACT FOR: Bid Package •%30)- HVPkt_ Sheet / al
CONTRACTOR'S ' ICAIION F 4 R PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment, . belo',in cone r ion with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet,AIA Document "�: ds ttached� completed in accordance with the Contract Documents,that all amounts have been paid
""•,‘., ,,,2 by the Contractor for Work for which previous Certificates for Payment were issued and
A payments received from the Owner,and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM 21.' $ 3,345,500.00
2. Net change by Change Orders $ 38,542.00 CONTRACTOR: AI
3. CONTRACT SUM TO DATE(Line 1 ±2) $ 3,384,042.00
4. TOTAL COMPLETED&STORED TO DATE $ 1,756,413.00 ' f ,,"+4 ._ / Q
(Column G on G703) By: Date: 06/�7/10/
5. RETAINAGE: 5%of Contract Total Joseph R. .nsdel 40 eside
a. 5 %of Completed Work $ 169,202.10 State of INDIA —7 County of MONROE
(Column D+E on G703) Subscribed and swo to before me is_ • /,, /� day of Lltie t „2009
b. 10 %of Stored Material $ 0.00 Notary Public: � ��,� �C1l�
(Column F on G703) My Commission expires: August 29,2014
Total Retainage(Lines 5a+5b or
Total in Column I ofG703) $ 169,202.10 CERTIFICATE FOR PAYMENT
6. TOTAL EARNED LESS RETAINAGE 1,587,210.90 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Line 5 1 otal) $ comprising this application,the Construction Manager and Architect certify to the
7. LESS PREVIOUS CERTIFICATES FOR Owner that to the best of their knowledge,information and belief the Work has
PAYMENT(Line 6 from prior Certificate) $ 1,348,335.90 progressed as indicated,the quality of the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE $ 238,875.00 Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH, INCLUDING RETAINAGE $ 1,796,831.10 �� 00
(Line 3 less Line 6) Al J/AM 23
OUNT CERTIFIED $ 7'L7( S
CHANGE ORDER SUMMARY AID1 l IONS DEDUC I IONS V (Attach explanation if amount certified differs from the amount applied for. Initial all
Total changes approved figures on this Application and on the Conan on Sheet that changed to conform to the
in previous months by Owner $38,542.00 amount certified A CO TRUCTI( /
Total approved this Month B . • 'PAGER:
Y '' r, C Date: 6 24 d9
AR 1'f tr1 J
COTALS $38,542.00 $0.00 By ,.T, ' � r Date:
NET CHANGES by Change Order $38,542.00 This Certificate"' ..negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance,payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
�• .• • •a. .. •. - •. •_ -• • -� •. •... ...r . ••. .. �.. . . .p .. I •a_ •-
THE AMERICAN INSTITUTE OF ARCHITECTS.1745 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006-5292
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
Ayr-J.-m.• A I IILAN HIVU L:kK I IFIGATE FOR PAYMENT MANAGER-ADVISER EDITION tilt AIA DOCUMENT G702/CMa ` Y
� PAGE ONE OF 4 PAGES
TO OWNER: PROJECT: Parcel 7A, Regl. A• tro 1-_ APPLICATION NO: I 1 Distribution to:
Carmel Redevelopment Commission Arts Center
‘ 14 �0o� nOWNER
One Civic Square 0 PERIOD TO: 5/31/09 CONSTRUCTION
• Carmel, IN 46032 PROJECT NO: 2695-4310 MANAGER
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER Shicl-S 4 . 'o., Inc. (PSM#14065) I (ARCHITECT
POYNTER SHEET METAL ATTN: Lynda Weaver,902 N. Capitol Avenue. I a'J apolis,IN 46204 CONTRACT DATE: 04/18/08 J (CONTRACTOR
8768 N. STATE RD. 37 VIA ARCHITECT:
BLOOMINGTON. IN 47404
CONTRACT FOR: Bid Package#4310-HVAC Sheet Metal
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet,A1A Document G703, is attached. completed in accordance with the Contract Documents,that all amounts have been paid
by the Contractor for Work for which previous Certificates for Payment were issued and
1. ORIGINAL CONTRACT SUM payments received from the Owner,and that current payment shown herein is now due.
2. Net change by Change Orders $ 3,345,500.00
$ 38,542.00 CONTRACTOR:
3. CONTRACT SUM TO DATE(Line 1 ±2) $ 3,384 042.00
4. TOTAL COMPLETED&STORED TO DATE W/
$ (,498,1 51.00 ,�
(Column G on G703) By:
s!� ��� Q�///O
5. RETAINAGE: Date: �
a. 10 %of'Com Completed Work $ Joseph R 14. Presi•-nt
P 149,815.10 State of: MO 4■T _
(Column D+E on G703)
Subscribed and swo to before me this ��/Q/� County a of MONROE 0
b. 10 %of Stored Material $ 0.00 Nary Public: �G�Z "y / ��
(Column F on G703) M Commission x Tres: ugust 29,2 4
Total Retainage(Lines 5a+5b or
Total in Column I of G703) $ 149,815.10 .� a I - • A V
6. TOTAL EARNED LESS RETAINAGE 1,348,335.90 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Line 5'Total) $ comprising this application,the Construction Manager and Architect certity to the
7. LESS PREVIOUS CERTIFICATES FOR Owner that to the best of their knowledge,information and belief the Work has
PAYMENT(Line 6 from prior Certificate) $ 1,203,008.40 progressed as indicated,the quality of the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE $ 14>,527.50 Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH, INCLUDING RETAINAGE $ 2,035,706.10
(Line 3 less Line 6) AMOUNT CERTIFIED $ I E) j I ,•
(Attach explanation if amount certified differs from the amount applied fbr. Initial all
'total changes approved figures on this Application and on the Continuation Sheet that changed to conform to the
in previous months by Owner amount certifies
Total approved this Month CO 'TRUCT Si. u: AGER: / IP
$38,542.00 By: 1.,• i:,.�s.*iffy / •
AR --- C Date: Z b
TOTALS $38,542.00 $0.00 By: ° Dater
NET CHANGES by Change Order $38,542.00 This Certificat- 's no egotiable. The AMOUNT CERTIFIED is payable only to the
Contractor ',met erein.Issuance,payment and acceptance of payment are without
prejudice .• . rights of the Owner or Contractor under this Contract.•
THE AMERICAN INSTITUTE OF ARCHITECTS,1745 NEW YORK AVE..N.W.,WASHINGTON,DC 20006-5292 ,• • •, • •, •• V i a-
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
•
' ' '• •�'��• �" • `+• • n • •�•�.. • 1/4/1•0 i RVV i I• I• IYirtivmVCI[-/1UVIJCR CIJI I!VIM
AL4 DOCUMENT G702/CMa
PAGE ONE OF 4 PAGES
TO OWNER: PROJECT: Parcel 7A, Regional Performing APPLICATION NO: 10 Distribution to:
Carmel Redevelopment Commission Arts Center
One Civic Square nOWNER
Carmel, IN 46032
PERIOD TC): 4/30/09 (CONSTRUCTION
PROJECT NO: 2695-4310 MANAGER
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: Spiel-Sexton Co., Inc.
(PSM#14065) El ARCHITECT
POYNTER SHEET METAL ATTN:Lynda Weaver,902 N.Capitol Avenue,Indianapolis,IN 46204 CONTRACT DATE: 04/18/08
8768 N. STATE RD. 37 VIA ARCHITECT: CONTRACTOR
BLOOMINGTON,IN 47404
CONTRACT FOR Bid Package#4310-HVAC Sheet Metal
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's k .wledge, •Application is made for payment,as shown below,in connection with the Contract. - '
Continuation Sheet,AIA Document G703,is attached. information and belief the Work covered by this Application for Payments been
completed in accordance with the Contract Documents,that all amounts ha'f been a_id, .^l,
by the Contractor for Work for which previous Certificates for Payment wet; issued d. •
1
1. ORIGINAL CONTRACT SUM payments received from the Owner,and that current payment yment shown herein now due:-
$ 3,345,300.00 t r...i�
2. Net change by Change Orders $ 0.00 CONTRACTOR: I•3. CONTRACT SUM TO DATE(Line 1 +-2)
4. TOTAL COMPLETED&STORED TO DATE $ 3,345,300.00
(Column G on G703) $ 1,336,6T6.00 �� r '/�+ �1
iv
5. RETAMAGE: By: �jrf `
4,----_-_..--
a. f 0 %of Completed Work Joseph • 1• Presi -nt Da ..–�..--
p $ 133,667.60 State of: ► • County of MO -ROE—
(Column D+E on 0703) Subscribed ands o to before met is .7
b. 10 %of Stored Material $ 0.00i Cut day of /4�/'�'/ a2009
o umn F on G703) Notary Public: C.
'I otal Retainage(Lines 5a+5b or My Commission expires: August 29,2 14
•
Total in Column I of G703) $ 133,667.60 • • e • • 1
6. TOTAL EARNED LESS RETAINAGE 1,203,008.40 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Line 5 Total) comprising this application,the Construction Manager and Architect certify to the
7. LESS PREVIOUS CERTIFICATES FOR Owner that to the best of their knowledge,information and belief the Work has
PAYMENT(Line•6 from prior Certificate) $ 1,065,872.70 1 progressed as indicated,the quality of the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE $ 137,135.70 ,.l Documents,and the Contractor is entitled to payment ot'the AMOUNT CERTIFIED.
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 2,142,291.60 7 -J
(Line 3 less Line 6) AMOUNT CERTIFIED $ l 31 It 13S i
CHANGE ORDER SUMMARY AUDI!IONS. UEDUC I IONS – (Attach explanation if amount certified differs from the amount applied or. Initial all -~
Total changes approved figures on this Application and on the Continuation Sheet that changed ged to conform to the
in previous months by Owner amount certified)
Total approved this Month CONSTRUCTION MANAGER: f '
ARCH1TE 7 �` z._.- _ Date: T 13b�1( c/��9,
TOTALS $0.00 $0.00 By: /e - zi-30'��(
NET CHANGES by Change Order Date:
$0.00 This Ce '•ica ' is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contra,to amed herein. Issuance,payment and acceptance of payment are without
71-A pUWMEN I G/OZ/(-.Ma•AF—7C.A1I• M•. t' rll.A ION -OK NA M>_Na•C•rIS -.rr •• •,,. prejud ce to any rights of the Owner or Contractor under this Contract.
THE AMERICAN INSTITUTE OF ARCHITECTS.1745 NEW YORK AVE..N.W.,WASHINGTON,DC 20006-5292 ••, -�• •• •- �' • A •91 GN2/l,Me-19.1
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
i •• .• • -•• •v•- if-All IN/V v•...•l•• •■ •vim • ■ v•% • •-• ■ 1••_•• • vVIVJ I RV S.+I I.J IV WIMP//-'1%.2 CR-M IJ V IJCR IC 1J1 I IS)IV
AIA•DOCUMENT G702/CMa PAGE ONE OF 4 PAGES
TO OWNER: PROJECT: Parcel 7A,Regional Performing APPLICATION NO: 9 Distribution to:
Carmel Redevelopment Commission Arts Center nOWNER
One Civic Square PERIOD TO: 3/31/09 nCONSTRUCTION
Carmel,IN 46032 PROJECT NO: 2695-4310 MANAGER
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: Shiel-Sexton Co.,Inc. (PSM#14065) IARCHITECT
POYNTER SHEET METAL ATTN: Lynda Weaver,902 N. Capitol Avenue,Indianapolis,IN 46204 CONTRACT DATE: 04/18/08 nCONTRACTOR
8768 N. STAT.E RD. 37 VIA ARCHITECT:
BLOOMINGTON,IN 47404
CONTRACT FOR: Bid Package#4310-HVAC SEJ,etial,'\;
CONTRACTOR'S APPLIC.A•-fO 'N'� O `P° YMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
� � � ,
Application is made for payment,as sh el'� i`(��onnection wit th Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet,AIA Document C7ff3\.ss, tlae'hed. ,-j,; �.1✓ completed in accordance with the Contract Documents,that all amounts have been paid
',\�\ ' 0 <, j+ by the Contractor for Work for which previous Certificates for Payment were issued and
%. . 0'... payments received from the Owner,and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM 3,345,300.00
2. Net change by Change Orders U� 5 0.00 CONTRACTOR: _
3. CONTRACT SUM TO DATE(Line 1 2) ---' $ 3,345,300.00
4. TOTAL COMPLETED&STORED TO A�TF/...- $ 1,184,303.00 IPA ',S
(Column G on G703) \.,„„......- By: �.■ !' w' I� . Date: (13//8/0
5. RETAINAGE: Joseph R. ansd- • nt /
a. 10 %of Completed Work $ 118,430.30 State of IN I • A WI County of: MONK Zit(Column D+E on G703) Subscribed and s o to le ore me his / day of Ma-'cJj o'Z
b. 10 /o of Stored Material $ 0.00 Notary Public:
(Column F on G703) My Commission expires: 7lugust 29,201 /
"Total Retainage(Lines 5a+5b or
Total in Column I of G703) $ 118,430.30 CERTIFICATE FOR PAYMENT
6. TOTAL EARNED LESS RETAINAGE 1,065,872.70 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Line 5 Total) S comprising this application,the Construction Manager and Architect certify to the
7. LESS PREVIOUS CERTIFICATES FOR Owner that to the best of their knowledge,information and belief the Work has
PAYMENT(Line 6 from prior Certificate) $ 982,161.00 progressed as indicated,the quality of the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE $ 83,7'l 1.70 Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 2,279,427.30 /�111 ‘�
(Line 3 less Line 6) 1/ AMOUNT CERTIFIED $
CHANGE ORDER SUMMARY ADDI I IONS DEDUC I IONS 7 (Attach explanation if amount certified differs from the.mount applied for. Initial all
Total changes approved figures on this Application and on the Continuation; ,t that changed to conform to the
in previous months by Owner amount certified.)
CO \ RUCT-I1 A►,•,-• "". - �7
Total approved this Month By: �:.� l 1,44. %a„.AI Date: "3 G-- cs
ARC i ECT:.. . ar ' ,.,,,
TOTALS $0.00 $0.00 By f Date: )'
NET CHANGES by Change Order $0.00 This Certificate is n..-,:-.'go •1 e. The A .1__
T CERTIFIED is payable only to the
Contractor n. 1 °erein.Issuance,payment and acceptance of payment are without
prejudice t.... ''rights of the Owner or Contractor under this Contract.
THE AMERICAN INSTITUTE OF ARCHITECTS,1745 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006-5292
Users may obtain validation of this document by requesting of the license a completed MA Document D401 -Certification of Document's Authenticity
•
AtILIUA i ION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER-ADVISER EDITION
AM DOCUMENT G702/CMa PAGE ONE OF 4 PAGES
TO OWNER: PROJECT: Parcel 7A, Regional Performing APPLICATION NO: 8 Distribution to:
Carmel Redevelopment Commission Arts Center 10WNER
One Civic Square PERIOD TO: 2/28/09 CONSTRUCTION
Carmel,IN 46032 PROJECT NO: 2695-4310 MANAGER
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: Shiel-Se n ., (PSM#14065) ARCHITECT
POYNTER SHEET METAL ATTN: Lynda Weaver,902 N.Capitol Avenue,Indian of 466204 CONTRACT DATE: 04/18/08 CONTRACTOR
8768 N. STATE RD.37 VIA ARCHITECT:
BLOOMINGTON,IN 47404 /5-) '6 CONTRACT FOR: Bid Package#4310-HVAC Sheet Meta •
CONTRACTOR'S APPLICATION FOR PAYMENT \ un'. signed Co• .ctor certifies that to the best of the Contractor's knowledge.
Application is made for payment,as shown below,in connection with the Contract. r . .ation and b•t'f the Work covered by this Application for Payment has been
Continuation Sheet,AIA Document G703,is attached. co . - ed in a orrdance with the Contract Documents,that all amounts have been paid
by t Co r. or for Work for which previous Certificates for Payment were issued and
payme41. from the Owner,and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM $ 3,345,300.00
2. Net change by Change Orders 5 0.00 CONTRACTOR:
3. CONTRACT SUM TO DATE(Line 1±2) $ 3,345,300.00
4. TOTAL COMPLETED&STORED TO DATE $ 1,091,290.00 qt�.I 1�
(Column G on G703) By: ./.. �' '+� Date: O3/0
5. RETAINAGE: Joseph R.I ansdelialres.de t
a. 10 %of Completed Work $ 109,129.00 State of INDI+NA WI County of MONROE
o umn D+E on G703) Subscribed ands m to .e ore m thhiiss oZ-� day of MQc–ch a 9
b. 10 %of Stored Material 5 0.00 Notary Public: -mil /
( o umn F on G703) My Commission expires: August 29,2014
'total Retainage(Lines 5a+56 or
Total in Column I of G703) $ 109,129.00 CERTIFICATE FOR PAYMENT
6. TOTAL EARNED LESS RETAINAGE 982,161.00 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Line 5 Total) $ comprising this application,the Construction.Manager and Architect certity to the
7. LESS PREVIOUS CERTIFICATES FOR Owner that to the best of their knowledge,information and belief the Work has
PAYMENT(Line 6 from prior Certificate) $ 755,432.10 progressed as indicated,the quality of the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE $ 226.728.90 Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 2,363,139.00
(Line 3 less Line 6) j AMOUNT CERTIFIED $ 226,728.90
CHANGE ORDER SUMMARY ADDI HUNS DEDUCTIONS ' (J (Attach explanation if amount certified differs rom the amount applied for. Initial all
Total changes approved \ figures on this Application and on the Conti .•lion Sheet that changed to conform to the
in previous months by Owner amount certifie•
CO TRUCTIII ; j.GER:
Total approved this Month - By: ►.fia`Tie ri ,y,,�,. .- — ■ Date: .0-57 i g'
ARC'1—EC : r -
TOTALS $0.00 $0.00 By: ' Date: i '
NET CHANGES by Change Order • $0.00 This Certificate is ,a' _...-:. e. The AMOUNT CERTIFIED is payable only to the
Contractor na c.- :,,_ . ssuance,payment and acceptance of payment are without
prejudice to -•i.. is of the Owner or Contractor under this Contract.
THE AMERICAN INSTITUTE OF ARCHITECTS.1745 NEW YORK AVE.,N.W.WASHINGTON,DC 20006-5292-
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
.-.. • 1-1vr.. two. "'mu vGR 1 Ir1'..H I C rVrr rM T IVICIV I CONSTRUCTION MANAGER-ADVISER EDITION
ALA DOCUMENT G702/CMa PAGE ONE OF 4 PAGES
TO OWNER: PROJECT: Parcel 7A, Regional Performing APPLICATION NO: 7 Distribution to:
Carmel Redevelopment Commission Arts Center OWNER
One Civic Square PERIOD TO: 1/31/09 CONSTRUCTION
Carmel,IN 46032 PROJECT NO: 2695-4310 MANAGER
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: Shiel-Sexton Co.,Inc. (PSM#14065) ARCHITECT
POYNTER SHEET METAL ATTN:Lynda Weaver,902 N.Capitol Avenue,Indianapolis.IN 46204 CONTRACT DATE: 04/18/08 ]CONTRACTOR
8768 N. STATE RD. 37 VIA ARCHITECT:
BLOOMINGTON,IN 47404
CONTRACT FOR: Bid Package#4310-HVAC Sheet Metal
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet,AIA Document G703,is attached. completed in accordance with the 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,and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM $ 3,345,300.00
2. Net change by Change Orders $ 0.00 CONTRACTOR:
3. CONTRACT SUM TO DATE(Line 1±2) $ 3,345,300.00
9
4. TOTAL COMPLETED&STORED TO DATE $ 839,369.00
(Column G on G703) By: ' f ..j,, _. Date: 01/44//
5. RETAINAGE: Joseph R.L4nsdel resid•.t
a. 10 %of Completed Work $ 83,936.90 State of INDYs NA County of MONROE
Column D+Eon G703 +C� �����/ &Q'9
( ) Subscribed and •r- co..- 9re m t is �/ day of
b. 10 %of Stored Material $ 0.00 Notary Public: i
(Column F on G703) My Commission expires: ugust 29,2014
l'otal Retainage(Lines 5a+5b or
Total in Column I of G703) $ 83,936.90 CERTIFICATE FOR PAYMENT
6. TOTAL EARNED LESS RETAINAGE 755,432.10 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Line 5 1 otal) 1. comprising this application,the Construction Manager and Architect certify to the
7. LESS PREVIOUS CERTIFICATES FOR Owner that to the best of their knowledge,information and belief the Work has
PAYMENT(Line 6 from prior Certificate) $ 652,652.10 progressed as indicated,the quality of the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE $ 102,780.00 Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 2,589,867.90
(Line 3 less Line 6) AMOUNT CERTIFIED $ 102,780.00
CHANGE ORDER SUMMARY AUDI I IONS DEDUCI IONS (Attach explanation ifamount certified differs from the amount applied for. Initial all
total changes approved figures on this Application and on the Continuation Sheet that changed to conform to the
in previous months by Owner amount certified.)
CONST! _ ON MANAGER:
Total approved this Month By: `:kt". , Date: " 09
ARCHITECT:
TOTALS $0.00 $0.00 By: ''- Date: IV 0
NET CHANGES by Change Order $0.00 This Certifi•. e is no egotiable. The AMO 'CERTIFIED is payable only to th
Contracto ame. •rein.Issuance,payment and acceptance of payment are without
prejudic: o aI ights of the Owner or Contractor under this Contract.
. .• .. .a. ... �. ... - •. •- •. .' -. •. .... _,.. - . •.. .. ..� .. IA 'a- .•
THE AMERICAN INSTITUTE OF ARCHITECTS,1745 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006-5292
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
\r-f)-1I rjD' T \I, ---1
• 1,11 JAN 1 6 2009
.._.0
By _
APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER-ADVISER EDITION
AIA DOCUMENT G702/CMa PAGE ONE OF 4 PAGES
TO OWNER: PROJECT: Parcel 7A,Regional Performing APPLICATION NO: 6 Distribution to:
Carmel Redevelopment Commission Arts Center OWNER
One Civic Square PERIOD TO: 12/31/08 CONSTRUCTION
Carmel, IN 46032 PROJECT NO: 2695-4310 MANAGER
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: Shiel-Sexton Co.,Inc. (PSM#14065) PARCHITECT
POYNTER SHEET METAL ATTN: Lynda Weaver,902 N.Capitol Avenue,Indianapolis,IN 46204 CONTRACT DATE: 04/18/08 CONTRACTOR
8768 N. STATE RD. 37 VIA ARCHITECT:
BLOOMINGTON,IN 47404
CONTRACT FOR: Bid Package#4310-HVAC Sheet Metal
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet,AIA Document G703,is attached. completed in accordance with the 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,and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM $ 3,345,300.00
2. Net change by Change Orders $ 0.00 CONTRACTOR: di
3. CONTRACT SUM TO DATE(Line 1±2) $ 3,345,300.00
4. TOTAL COMPLETED&STORED TO DATE $ 725,169.00 ,i / Yea .
(Column G on G703) By: '- Date: AO�/�8/AO o
5. RETAINAGE: Joseph R. ansd"Presi e.nt
a. 10 %of Completed Work $ 72,516.90 State of IN D . ►_ />t County of MONROE
(Column D+Eon G703) Subscribed and swo n to before me hissx � ,�� day of Dec ihei' 02008
b. 10 %of Stored Material $ 0.00 Notary Public: I�/� �/1���� "
(Column F on G703) My Commission expires: ugust 29,2014
total Retainage(Lines 5a+5b or
Total in Column I of G703) $ 72,516.90 CERTIFICATE FOR PAYMENT
6. TOTAL EARNED LESS RETAINAGE 652,652.10 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Line 5 Total) $ comprising this application,the Construction Manager and Architect certify to the
7. LESS PREVIOUS CERTIFICATES FOR Owner that to the best of their knowledge,information and belief the Work has
PAYMENT(Line 6 from prior Certificate) $ 628,750.80 progressed as indicated,the quality of the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE $ 23.901.30 Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 2,692,647.90
(Line 3 less Line 6) AMOUNT CERTIFIED $ 23,901.30
CHANUE ORDER SUMMARY ADD!1 IONS DUDUL I IONS (Attach explanation if amount certified differs from the amount applied for. Initial all
1 otal changes approved figures on this Application and on the Continuation Sheet that changed to conform to the
in previous months by Owner amount certified)
CONST t _ 0 \ •NAGER:
Total approved this Month By: . .... =iz Date: 1 Og
ARCHI EC : or 0
T
firr
OTALS $0.00 $0.00 By: ...211I. , Date: l '
NET CHANGES by Change Order $0.00 This Certific. is not -_. table. The •MOUNT CERTIFIED is payable only to the
Contractor aired - n.Issuance,payment and acceptance of payment are without
prejudic- .an is of the Owner or Contractor under this Contract.
AIA UULUMbNI to/ULLMa AYYLIt,A I ION ANU LtR 117IOA I ION F•' 'AYM NI GUNS RULI IS'MANAIotH-AU ° ••- '• ID • ' '• ' CO '•
THE AMERICAN INSTITUTE OF ARCHITECTS,1745 NEW YORK AVE..N.W.,WASHINGTON,DC 20006-5292
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
AIA DOCUMENT G7O2/CMa PAGE ONE OF 4 PAGES
TO OWNER: PROJECT: Parcel 7A, Regional Performing APPLICATION NO: 5 Distribution to:
Carmel Redevelopment Commission Arts Center nOWNER
One Civic Square PERIOD TO: 11/30/08 nCONSTRUCTION
Carmel, IN 46032 PROJECT NO: 2695-4310 MANAGER
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: Shiel-Sexton Co.,Inc. (PSM#14065) nARCHITECT
POYNTER SHEET METAL ATTN:Lynda Weaver,902 N.Capitol Avenue,Indianapolis,IN 46204 CONTRACT DATE: 04/18/08 (CONTRACTOR
8768 N. STATE RD. 37 VIA ARCHITECT:
BLOOMINGTON,IN 47404 ,p '
-: r'
CONTRACT FOR: Bid Package#4310-HVAC Sheet Metal S
`l
CONTRACTOR'S APPLICATION FOR PANT 'The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment,as shown below,in connection with the Contract. \'S) information and belief the Work covered by this Application for Payment has been
Continuation Sheet,AIA Document G703,is attached. \ corhpleted in accordance with the Contract Documents,that all amounts have been paid
;1 by the Contractor for Work for which previous Certificates for Payment were issued and
1. ORIGINAL CONTRACT SUM $ 3 payments received from the Owner,and that current payment shown herein is now due.
,345,300.00
2. Net change by Change Orders $ = 0.00 CONTRACTOR:
3. CONTRACT SUM TO DATE(Line I±2) $ 3,345,300.00
4. TOTAL COMPLETED&STORED TO DATE $ 698,612.00 /
(Column G on G703) By: " i '�. Date: //// /�
oZ
5. RETAINAGE: Joseph R ansd- Presi•-nt
a. 10%of Completed Work $ 69,861.20 State of: I D • AV/ County of: MONROE
TM—)umn D+Eon G703) Subscribed and swo to .e ore me is /o',Z, day of Hove -,i 0 8
b. 10 %of Stored Material $ 0.00 Notary Public: e� � <��a� �ti✓Cf'
o umn F on G703) My Commission expires: August 29,2014
Total Retainage(Lines 5a+5b or
Total in Column I of G703) $ 69,861.20 CE-TIFICATE FOR PAYMENT
6. TOTAL EARNED LESS RETAINAGE 628,750.80 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Line 5 1 otal) $ comprising this application,the Construction Manager and Architect certily to the
7. LESS PREVIOUS CERTIFICATES FOR Owner that to the best of their knowledge,information and belief the Work has
PAYMENT(Line 6 from prior Certificate) $ 607,050.00 progressed as indicated,the quality of the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE $ 21,700.80 Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 2,716,549.20
(Line 3 less Line 6) AMOUNT CERTIFIED $ 21,700.80
■
CHANGE,ORDER SUMMARY AUDI 1 IONS DhDUC HUNS (Attach explanation if•amount certified differs from the amount applied for. Initial all
Iota!changes approved figures on this Application and on the Continuation Sheet that changed to conform to the
in previous months by Owner amount certified.)
CONSTRUCTI•. • AGER:
Total approved this Month By: gs*' re. Date: 1
ARCHITEC r , US
TOTALS $0.00 $0.00 By: Date:
NET CHANGES by Change Order $0.00 This Certificate is no egoti . - e AMOUNT CERTIFIED is payable only to the
Contractor name. erein. . uance,payment and acceptance of payment are without
prejudice to any ght. the Owner or Contractor under this Contract.
THE AMERICAN INSTITUTE OF ARCHITECTS,1745 NEW YORK AVE..N.W.•WASHINGTON.DC 2000$-5292
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
AIA L 'JCUMENT G702/CMa
•---•- • 1.vwa I rout..I ION MANAGER-ADVISER EDITION
PAGE ONE GP 4 PAGES
TO OWNER: PROJECT: Parcel 7A,Regional Performing APPLICATION NO: 4 Distribution to:
Carmel Redevelopment Commission Arts Center
One Civic Square Q OWNER
PERIOD TO: 10/31/08 000NSTRUCTION
Carmel, IN 46032 •
PROJECT NO: 2695-4310
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: Shiel-Sexton Co.,Inc. MANAGER
POYNTER SHEET METAL ATTN:Lynda Weaver,902 N.Capitol Avenue,Indianapolis.IN 46204 CONTRACT DATE:PO4/18 0865) 17CONT ACT
8768 N. STATE RD.37 VIA ARCHITECT: nCONTRACTOR
BLOOMINGTON,IN 47404
CONTRACT FOR: Bid Package#4310-HVAC Sheet Metal
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment,as shown below,in connection with the Contract.
Continuation Sheet,AIA Document G703,is attached. information and belief'the Work covered by this Application for Payment has been
completed in accordance with the Contract Documents,that all amounts have been paid
by the Contractor fbr Work for which previous Certificates for Payment were issued and
1. ORIGINAL CONTRACT SUM $ 3,345,300.00 payments received from the Owner,and that current payment shown herein is now due.
2. Net change by Change Orders $ 0.00 CONTRACTOR:
3. CONTRACT SUM TO DATE(Line l f 2) $ 3,345,300.00
4. TOTAL COMPLETED&STORED TO DATE $ 674,500.00
(Column G on G703) fir;
5. RETAINAGE:
By: !` �,nt r0 a7/4177
Joseph • ansd= nt Date:
a. 10 %of Completed Work $ 67,450.00 State of I L, AN•.WF
(Column D+Eon G703) Subscribed and sworn o .e ore me t}�is y County of MONROE 10 %of Stored Material $ 0.00 Notary Public: (�y / day of Off/ a�
(Column F on G703) - u
Total Retainage(Lines 5a+5b or My Commissio exp es: ugust 29,2
Total in Column I of G703) $ 67,450.00 CERTIFICATE FOR PAYMENT
6. TOTAL EARNED LESS RETAINAGE 607,050.00 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Line 5 1 otal) $ comprising this application,the construction Manager and Architect certify to the
7. LESS PREVIOUS CERTIFICATES FOR Owner that to the best of their knowledge,information and belief the Work has
PAYMENT(Line 6 from prior Certificate) 5 89,100.00 progressed as indicated,the quality of the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE . $ 17,950.0(1 s/ Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 2,738,250.00
(Line 3 less Line 6) AMOUNT CERTIFIED
CHAN h ORDER SUMMARY AUDI.1IONS llhllUC I IONS $ 517,950.00
'Iota]changes approved (Attach explanation if amount certified dyers from the amount applied for. Initial all
in previous months by Owner figures on this Application and on the Continuation Sheet that changed to conform to the
amount certified.)
Total approved this Month CONSTRUCTIO u ' AGER:
By: At& Date: <O Z'05'TOTALS ARCHITECT: (f P r I l';IF
$0.00 $0.00 By:
NET CHANGES by Change Order $0.00 Date: Iii �!! .
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein.Issuance,payment and acceptance of payment are without
AIA UUUUMtN I U/UL/UMa•AV'F'LILA I IUN ANU UtH III-ILA)IUN 1-UK F'AYMtN I•UUNS 1 KUL I IUN MANNbtK-HUVIStK tUl I IUNr1
prejudice UN•A rights of the Owner or Contractor under this Contract.
THE AMERICAN INSTITUTE OF ARCHITECTS,1745 NEW YORK AVE.,NM.,WASHINGTON,DC 20005-5292
b/UYA448-1`9`1
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
Alf, DOCUMENT G702/CMa • PAGE ONE OF 4 PAGES
TO OWNER: PROJECT: Parcel 7A, Regional Performing APPLICATION NO: 3 Distribution to:
• Camel Redevelopment Commission Arts Center []OWNER
One Civic Square PERIOD TO: 9/30/08 []CONSTRUCTION
Carmel,IN 46032 PROJECT NO: 2695-4310 MANAGER
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: Shiel-Sexton Co.,Inc. (PSM#14065) []ARCHITECT
POYNTER SHEET METAL ATTN:Lynda Weaver,902 N.Capitol Avenue,Indianapolis,EN.46204 CONTRACT DATE: 04/18/08 [CONTRACTOR
8768 N. STATE RD.37 VIA ARCHITECT:
BLOOMINGTON,IN 47404 '
CONTRACT FOR: Bid Package#4310-HVAC Sheet Metal _,_% 2e��
CONTRACTOR'S APPLICATION FOR PAYMENT-'-- h' u ersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment,as shown below,in connection with the Contract. ' `(...Information and belief the Work covered by this Application for Payment has been
Continuation Sheet,AIA Document G703,is attached. completed in accordance with the 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,and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM $ 3,345,300.00
2. Net change by Change Orders $ 0.00• CONTRACTOR:
3. CONTRACT SUM TO DATE(Line I±2) $ 3,345,300.00
4. TOTAL COMPLETED&STORED TO DATE $ 99,000.00 * !,I` .
(Column G on G703) By: Date: Q4//0O8
5. RETAINAGE: Joseph.R. •Isdel W'eside
a. 10 %of Completed Work $ 9,900.00 State of: IND • A County of MONROE //��,, __ �l
(Column D+Eon G703) Subscribed and swo to before me thi _-fi rti ay of S2P o2�0Oa
b. 10 %of Stored Material $ 0.00 Notary.Public: 1
(Column F on G703) My Commission xpues: August 29,2 1
Total Retainage(Lines 5a+5b or •
Total in Column I of G703) $ 9,900.00 CERTIFICATE FOR PAYMENT
6. TOTAL EARNED LESS RETAINAGE 89,100.00 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Line 5 1 otal) $ comprising this application,the Construction Manager and Architect certify to the
7. LESS PREVIOUS CERTIFICATES FOR Owner that to the best of their knowledge,information and belief the Work has
PAYMENT(Line 6 from prior Certificate) $ 69,300.00 _ /progressed as indicated,the quality of the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE $ 19.800.011 V Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 3,256,200.00
(Line 3 less Line 6) AMOUNT CERTIFIED $ 19,800.00
CHANUL URDLR SUMMARY ADM IIONS DL.DUCIIONS (Attach explanation if amount certified differs from the amount applied for. Initial all
1 otal changes approved figures on this Application and on the Continuation Sheet that changed to conform to the
in previous months by Owner amount certified.)
CONSTRUCTION MANAGER:
Total approved this Month By: �k„t Date: #' Zr a
ARCHITECT:
TOTALS $0.00 $0.00 By: Date: fgt.nob
NET CHANGES by Change Order $0.00 This Certificate is •. -_o cable. T e AMOUNT CERTIFIED is payable only to the
Contractor nam-• n.Issuance,payment and acceptance of payment are without
prejudice to any rig is of the Owner or Contractor under this Contract.
AIA UULUMtNI I. I L•Ma•APPLILA NANU(.tR I1•IL•A11•N •RP' N •(,•N KU ION1VIANAG K.••VI tfi t. •N•1994 tU I•N•AIA•® •9L b/UGI.Ma-1 aL
THE AMERICAN INSTITUTE OF ARCHITECTS,1745 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006-5292
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
•
AtA JJUC.UM�1VJ C.i/UL/CCMa PAGE ONE OF 4 PAGES
TO OWNER: PROJECT: Parcel 7A,Regional Performing APPLICATION NO: 2 Distribution to:
Carmel Redevelopment Commission Arts Center El OWNER
One Civic Square PERIOD TO: 8/31/08 El CONSTRUCTION
Carmel,IN 46032 PROJECT NO: 2695 MANAGER
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: Shiel-Sexton Co.,Inc. (PSM#14065) (ARCHITECT
POYNTER SHEET METAL ATTN:Lynda Weaver,902 N.Capitol Avenue,Indianapolis,IN 46204 CONTRACT DATE: 04/18/08 CONTRACTOR
8768 N.STATE RD.37 VIA ARCHITECT:
BLOOMINGTON,IN 47404
CONTRACT FOR: Bid Package#4310-HVAC Sheet Metal
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet,AIA Document G703,is attached. completed in accordance with the 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,and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM $ 3,345,300:00
2, Net change by Change Orders $ 0.00 CONTRACTOR:
3. CONTRACT SUM TO DATE(Line 1±2) $ 3,345,300.00
4. TOTAL COMPLETED&STORED TO DATE $ 77,000.00 : f,�
(Column G on G703) By: *' ( �' Date: C2870e/OF
•
5. RETAINAGE: Joseph R.Li sdell eside /
a. 10 %of Completed Work $ 7,700.00 State of: IND •- A W ji. County of MONROE
(Column D+E on G703) Subscribed and swo to 'e ore me th' ay of A.(�p(,(S7L o z:x:2E
b. 10 %of Stored Material . 5 0.00 Notary Public: l/`� `.J /
(Column F on G703) My Commissio expires: August 29,20
Total Retainage(Lines 5a+5b or
Total in Column I of G703) ' $ 7,700.00 CERTIFICATE FOR PAYMENT
6. TOTAL EARNED LESS RETAINAGE 69,300.00 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Lme 5'1 otal) $ compnsmg this application,the Construction Manager and Architect certity to the
7. LESS PREVIOUS CERTIFICATES FOR ' Owner that to the best of their knowledge,information and belief the Work has
PAYMENT(Line 6 from prior Certificate) $ 55,260.00 /progressed as indicated,the quality of the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE $ 14,040.00 s1/4 Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED.
t
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 3,276,000.00 , /)---"
(Line 3 less Line 6) AMOUNT CERTIFIED $ 14,040.00
CHANGE ORDER SUMMARY AUDI I IONS DEM HUNS (Attach explanation if amount certified differs from the amount applied for. Initial all
Total changes approved figures on this Application and on the Continuation Sheet that changed to conform to the
in previous months by Owner amount certified.)
CON r •' MANAGER:
Ina Total approved this Month By: �
ARC1-u I E w �y,
TOTALS $0.00 $0.00 By: / �,� \ Date:Date: .•X�•
NET CHANGES by Change Order $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein.Issuance,payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
AIAU•..UMiN la/U2IGMa• •'YL LAIIUN•,• K II-LA IUN •- -' ' • '',UN IK• I •'MA''0 N-'•• -t.• •N 9' • •N''TFw'4099W G4 u2JLMa-1994
THE AMERICAN INSTITUTE OF ARCHITECTS,1745 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006.5292
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
•
PAGE ONE OF 4 PAGES
TO OWNER: PROJECT: Parcel 7A,Regional Performing APPLICATION NO: 1 Distribution to:
Carmel Redevelopment Commission Arts Center
OWNER
One Civic Square PERIOD TO: 7/31/08 CONSTRUCTION
Cannel,IN 46032 PROJECT NO: 2695 MANAGER
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: Shiel-Sexton Co.,Inc. (PSM#14065) ARCHITECT
POYNTER SHEET METAL ATTN:Lynda Weaver,902 N.Capitol Avenue,Indianapolis,IN 46204 CONTRACT DATE: 04/18/08 CONTRACTOR
8768 N. STATE RD. 37 VIA ARCHITECT:
BLOOMINGTON,IN 47404
CONTRACT FOR: Bid Package#4310-HVAC Sheet Metal
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet,AIA Document G703,is attached. completed in accordance with the Contract Documents,that all amounts have been paid
by the Contractor for Work for which previous Certificates for Payment were issued and
1. ORIGINAL CONTRACT SUM payments received from the Owner,and that current payment shown herein is now due.
$ 3,345,300.00
2. Net change by Change Orders $ 0.00 CONTRACTOR:
3. CONTRACT SUM TO DATE(Line 1±2) $ 3,345,300.00
4. TOTAL COMPLETED&STORED TO DATE $ 61,400.00 4;; • .I ,'
(Column G on G703) / ,� O�js/DF
5. RETAINAGE: By: Date:
a. 10 %of Completed Work $ 6,140.00 Joseph R.4nsdel m wide
(Column D+Eon G703) State ■of INDh '. : !� County of:MONROE
—
b. 10 %of Stored Material Subscribed and o to before is day• of J u_ ace
(Column F on G703) $ 0.00 Notary Public: lJl •i ■ y I I t
Total Retainage(Lines 5a+5b or My Commission expires: August 29,2014
Total in Column I of G703) $ 6,140.00 CERTIFICATE FOFZ PA?101EAT
6. TOTAL EARNED LESS RETAINAGE 55,260.00 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 less Line 5'1 otal) $ comprising this application,the Construction Manager and Architect certify to the
7. LESS PREVIOUS CERTIFICATES FOR Owner that to the best of their knowledge,information and belief the Work has
PAYMENT(Line 6 from prior Certificate) $ 0.00 progressed as indicated,the quality of.the Work is in accordance with the Contract
8. CURRENT PAYMENT DUE $ 5x,260.00 Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 3,290,040.00_
(Line 3 less Line 6) AMOUNT CERTIFIED $ 55,260.00
CHANU1E,ORDER SUMMARY AJDII ION S DEDUCIIONS (Attach explanation if amount certified differs from the amount applied for. Initial all
Total changes approved figures on this Application and on the Continuation Sheet that changed to conform to the
in previous months by Owner amount certified.)
CONSTRUCT AGER:
Total approved this Month
By: Date: •.
ARCHITECT: •
TOTALS $0.00 $0.00 By: Date: 1111,
NET CHANGES by Change Order $0.00 This Certificate is. egotiable. The AMOUNT CERTIFIED is payable only to the •
Contractor named herein.Issuance,payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
AIA UULUMtN1 O/U14,Ma•APP LAIIUN ANU LEN III.1CA IIUN I-U•PA NI NI•I,UNS Ul,IlU MANAOtN-A•VI t EL, !UN-. •• t• I U`•AIA•511992
THE AMERICAN INSTITUTE OF ARCHITECTS,1745 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006-5292 /u1Jl,Ma•1 yJL
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity